Viola Rental Application

Fill in the application and select your Instrument Quality and Accessory Options

Privacy Policy - Our privacy policy is simple we will NEVER sell, trade, rent or ever make available your information to any third parties.
The information given here will only be used by Tegeler Music to qualify applicants for the purpose of renting an instrument.

Renter Information ?

Physical Address Please
State: Zip:
Residence:

| Years at Residence ?

Home Phone: (example: xxx-xxx-xxxx)
Cell Phone: (example: xxx-xxx-xxxx)
Employer:

Employers Phone: (example: xxx-xxx-xxxx)
Social Security #: (example: xxx-xx-xxxx) Why we need your SS#
Email:
Confirm Email:

Student Information

State: Zip:

Don't see your school on the list? No problem. Just enter the name of your school above and we'll contact you to arrange delivery of your instrument. Please feel free to request a visit from one of our associates so your school can start taking advantage of our services.

Select Grade Level:




Choose your
Preferred Instrument Quality

Condition
$22.00
*
$18.00
The monthly payment listed does not include sales tax but does include a $6.00 M&R fee covering all repairs and/or maintenance work that may need to be done to keep your instrument in top playing condition.
*There are limited quantities of Previously Played Instruments . If you choose this option and your choice is not currently available you will automatically be upgraded to a new condition instrument.


How to Select the Right Size Instrument

Choose your Accessories


Stand Color

- Book Level One Book, as designated by your Band Director


Please Choose Your Payment Method

SSL

/
CVV Code: 3 digit code on the back of the card
Coupon Code:




Your name here will represent your digital signature verifying you agree to the terms and conditions of this rental agreement.

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