Instrument Rental Request - Sullivan Violins

1Instrument Information

2Renter Information

3Player Information

4Additional Information

Renter Information

Name*

First Last

Billing Address*

Street Address City State ZIP Code

Email*

Phone*

Player Information

Name*

First Last

Music School

Teacher

Lease Start Date

Additional Information

For instrument rentals, Sullivan Violins requires a credit card AND either a debit card, checking account, or second credit card. One will be your primary payment method, while the second form of payment will be used as a backup in case of an inability to collect from the primary payment method. Cash is not accepted for rental charges. Please note: This is NOT a rent-to-own program. Up to 12 months of rental equity can be used toward purchase. See Rental Terms and Conditions for more information.

By submitting this form, you agree to Sullivan Violins' Rental Terms and Conditions.*

I agree

How did you hear about us?

Teacher/school

Online search

Word of mouth

Other

Comments or Questions

CAPTCHA

Name

This field is for validation purposes and should be left unchanged.

Instrument Rental Request Form

Instrument Information

What type of instrument is required?

Renter Information

Player Information

Additional Information