Bigel Music Rental Reservation

Please fill out the application below to reserve an instrument for a three month rental. After filling out the application you will be directed to a page where you can pay for the rental using Paypal.

Select instrument to rent:

Parent/ Guardian or Lessee's Name:

Email:

Mailing Street Address:

City: State: Zip:

Place of Employment:

Student's Name:

School:

Home Phone (9999999999):

Business Phone (9999999999):

Date to pick up instrument (mmddyy):

Location to pick up instrument (please choose one):

School

Bigel Music

By filling out this application online you are making a reservation to receive one of the instruments you selected for an initial rental of 3 months. You will still be required to sign a rental contract and include a credit card number for collateral, driver’s license for verifying identification, and contact information for a relative who lives in a different address than yours. By checking this box, you agree to the above conditions and attest that the information filled out is correct.

Please check the box to agree to the reservation: I agree Please agree to the reservation.

Date (mmddyy):