The Loft Violin Shop Rental Application

Choose Your Instrument

Instrument *

Violin

Viola

Cello

Bass

Violin Size *

Initial Payment $40.00

Violin (First and Last Month's Rent)

Viola Size *

Initial Payment $40.00

Viola small (First and Last Month's Rent)

Initial Payment $60.00

Viola large (First and Last Month's Rent)

Cello Size *

Initial Payment $80.00

Cello (First and Last Month's Rent)

Bass Size *

3/4

1/2

1/4

1/8

Initial Payment $100.00

Bass (First and Last Month's Rent)

Student and School Information

Student's First Name *

Student's Last Name *

School District *

Columbus *

Woodcrest Elementary

Other

If school district is other:

Which SCHOOL does your child attend?

Dublin Middle Schools *

Karrer Middle School

Grizzell Middle School

Davis Middle School

Sells Middle School

Reynoldsburg Schools pick up in the store. You will get an email from your teacher to remind you to pick up your new instrument before school starts.

Pick-up, Delivery, or Parcel Post? *

Pick-up in Store

Deliver to School

Send via Post

One time shipping charge for violin or viola: $25

One time shipping charge for cello: Approximately $75

We will contact you with the exact amount for cello before shipping.

Pick-up or Parcel Post? *

Pick-up in Store

Send via Post

One time shipping charge for violin or viola: $25

One time shipping charge for cello: Approximately $75

We will contact you with the exact amount for cello before shipping.

Accessories

Not sure what your school recommends or requires? Check here.

Music Books

Sound Innovations ($8.99)

Essential Elements for Strings ($9.99)

New Directions ($8.95)

All for Strings ($8.95)

Suzuki Book 1 with CD ($19.99)

Suzuki Book 1 without CD ($8.99)

Music Stands

Hamilton Standard Metal Music Stand ($16.00)

Optional Accessories

Everest Shoulder Rest Violin / Small Viola ($15.00)

Everest Shoulder Rest Large Viola ($25.00)

Sumi Shoulder Rest Violin / Small Viola ($15.00)

Sumi Shoulder Rest Large Viola ($22.00)

Kun Shoulder Rest Violin / Small Viola ($30.00)

Kun Shoulder Rest Large Viola ($40.00)

Worthington Christian Package

** Your new rental outfit

includes a foam shoulder

rest (at no charge).

These items are a separate

and optional purchase.

** The Worthington Chrisitian Package includes Essential Elements Book 1, Suzuki CD 1, and Deluxe Strukture music stand with bag

Accessories Subtotal (before tax):

0.00

Accessories Subtotal (including tax):

0.00

Adult Renter Information

** Person assuming financial responsibilty is the renter **

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email *

Renter's Employment Information

Business / Employer's Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Spouse's Employment Information

Spouse's First Name

Spouse's Last Name

Spouse's Business / Employer's Name

Street Address

Address Line 2

City

State

Zip Code

Phone Number

Payment Information

Your credit card will NOT be charged until you pick your new rental up at The Loft Violin Shop or prepared for school delivery. This information is for reserving the instrument.

Name on Card *

Credit Card Type *

Credit Card Number *

Expiration Date (mm/yy) *

Security Code *

Drivers License *

Date of Birth *

By providing your credit card information, your new rental account will be set-up as an autopay. Your monthly payments will be charged one month after the delivery or pick-up date.

Violin monthly rent $21.50 (including tax)

Viola (small) monthly rent $21.50 (including tax)

Viola (large) monthly rent $32.25 (including tax)

Cello monthly rent $43.00 (including tax)

Bass monthly rent $53.75 (including tax)

If you have any questions regarding payment, please email us at

violins@theloftviolinshop.com

Special Instructions