Instrument Rental Program Rent to Own Application

Instrument Rental Program Rent to Own Application
FILL OUT FORM COMPLETELY, PLEASE PRINT
Name*

First NameLast Name
Address*
City*
State*
Zip*
Social Security Number*
Home Phone*
Cell Phone*
Work Phone*
Email*
example@example.com
Employer*
Driver's License Number*
State*
Expires*
Student Name*
School*
Credit Card Number (No Debit)*
Expiration Date*

MonthDayYear
Date
Security Code*
Instrument*
About the Rent to Own program:

Music Doctors' Rent to Own Program is an affordable way for your child to try band or orchestra without having to purchase an instrument All your payments, less taxes and Maintenance & Repair (M&R) fees, apply toward the purchase of your instrument. If your student does not wish to continue with their instrument, the instrument can be returned to Music Doctors at any time. If payments are up to date, rental charges will stop after the instrument has been received and checked in.

Maintenance & Repair is included in your rental fees, and covers all repairs needed to keep the instrument in playing condition. It does not cover cleaning polishing or regular preventative maintenance, lacquered or plated finishes. Instrument accessories such as, but not limited to, head joint crowns, mouthpieces, ligatures, reeds, lyres, swabs, cases, drum heads, drum sticks, stands, snares, cork grease, lubricants or any other accessories are not included in the M&R Coverage. All repairs must be performed by Music Doctors' technicians. See complete conditions on contract.

Music Doctors, Inc. 2465 Memorial Blvd., Kingsport, TN 37664 nfo@musicdrs.com423-246-6220 To protect your personal information, please do not e-mail this form. Return in person or via USPS.
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Instrument Rental Program Rent to Own Application

FILL OUT FORM COMPLETELY, PLEASE PRINT