Harmony Music / Fowler Music Service
Anne Arundel County, Maryland
Rental Agreement
Special! 2nd and 3rd month FREE!
This site is protected by a dedicated SSL Certificate to ensure safe delivery of sensitive information.
All fields required.
Personal Information: Must match Credit/Debit Card
First Name:
Last Name:
Address:
City: State: Zip:
Home Phone:
Employer:
Work Phone:
Alternate Contact #1: Phone #:
Email Address (for company contact only):
Student's Name:
School: Pasadena Elementary School George Fox Middle School Oak Hill Elementary School Benfield Elementary School Jacobsville Elementary School Folger McKinsey Elementary School Shipleys Choice Elementary School High Point Elementary School Marley Elementary Echool Southgate Elementary School Severna Park Elementary School Woodside Elementary School Rippling Woods Elementary School Oakwood Elementary School Indian Creek School Sunset Elementary School Lake Shore Elementary School Glendale Elementary School Jones Elementary School Glen Burnie Park Elementary School Solley Elementary School Riviera Beach Elementary School Point Pleasant Elementary School Ft. Smallwood Elementary School Crofton Elementary School Crofton Woods Elementary School School Not Listed - Please Call 410.647.9537 for help
We will deliver to schools on the above list. Others are welcome to pre-order their instrument and pick it up at our shop.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Instrument Info and Monthly Charges:
Select Instrument and monthly charge: Flute - $19.95 plus $1.20 sales tax Clarinet - $19.95 plus $1.20 sales tax Trumpet - $19.95 plus $1.20 sales tax Trombone - $19.95 plus $1.20 sales tax Alto Saxophone - $39.95 plus $2.40 sales tax Percussion Kit (Drum & Bells) - $19.95 plus $1.20 sales tax 1/4 Size Violin - $19.95 plus $1.20 sales tax 1/2 Size Violin - $19.95 plus $1.20 sales tax 3/4 Size Violin - $19.95 plus $1.20 sales tax 4/4 Size Violin - $19.95 plus $1.20 sales tax 12 inch Viola - $19.95 plus $1.20 sales tax 13 inch Viola - $19.95 plus $1.20 sales tax 14 inch Viola - $19.95 plus $1.20 sales tax 15 inch Viola - $19.95 plus $1.20 sales tax 1/4 Size Cello - $39.95 plus $2.40 sales tax 1/2 Size Cello - $39.95 plus $2.40 sales tax 3/4 Size Cello - $39.95 plus $2.40 sales tax 4/4 Size Cello - $39.95 plus $2.40 sales tax
Optional Protection Plan covers the instrument against 3 specific cases of theft - see Item 12 below - $7.00 / month YESNO
Optional Damage Coverage covers the instrument for up to $275 of damage - see Item 13 below - $7.00 / month YESNO
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Credit Card Information:
Card Number: CCV Exp:
Name as it appears on Card:
Name on Card must match Name on Contract.
Bill my card monthly
Terms and Agreements:
I agree to the above Terms and Agreements and agree to pay the selected costs as indicated above.
HARMONY MUSIC FOWLER MUSIC SERVICE
17725 N.E. 65th Street #B235 602 Kent Avenue
Redmond, WA 98052 Pasadena, MD 21122