Harmony Music / Fowler Music Service

Anne Arundel County, Maryland

Rental Agreement

Special! 2nd and 3rd month FREE during FALL RENTAL SEASON - August 1st thru October 31st

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All fields required.

Personal Information:

First Name:    

Last Name:    

Address:   

City:    State:  Zip:  

Home Phone:   

Driver's License #   OR  Soc Sec #:   

Employer:    

Work Phone:     Position:    

Alternate Contact #1:     Phone #:    

Alternate Contact #2:     Phone #:    

Email Address (for company contact only):    

Student's Name:                             

School:  

We will deliver to schools on the above list. Others are welcome to pre-order their instrument and pick it up at our shop.

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Instrument Info and Monthly Charges:

Special! 2nd and 3rd month FREE during FALL Rental Season - August 1st through October 31st

Select Instrument and monthly charge:  

Optional Protection Plan covers the instrument against 3 specific cases of theft - see Item 12 below - $4.00 / month  

Optional Damage Coverage covers the instrument for up to $275 of damage - see Item 13 below - $4.00 / month  

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Credit Card Information:

Card Number:     Exp:    

Name as it appears on Card:    

Bill my card monthly

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Terms and Agreements:

 

HARMONY MUSIC                                                                                                                      FOWLER MUSIC SERVICE

17725 N.E. 65th Street #B235                                                                                                                                              8370 B&A Blvd. (at Wishing Well Florist)

Redmond, WA 98052                                                                                                                                                           Pasadena, MD 21122

800-356-2826                                                                                                                                                                       410-647-9537