New Rentals | Amadeus Strings | 105 Wennington Drive Poughkeepsie, NY 12603

Student's First Name*

Student's Last Name*

School*

School District*

Grade*

Teacher Name*

Has your teacher sized the student for an instrument?*

Violin

Viola

Cello

Bass

Package Type*

Instrument only, no package

Beginning Student Package ($30) - Arlington, Hyde Park, Monroe Woodbury: Central Valley, Pine Tree, Spackenkill, Wappingers (Essential Elements Book 1 + Folding Music Stand)

Beginning Student Package ($30) - Cornwall, Monroe Woodbury: North Main (Sound Innovations Book 1 + Folding Music Stand)

Beginning Student Package ($30) - Kingston (Strings Basic Book 1 + Folding Music Stand)

Beginning Student Package ($30) - Montessori of NP (I Can Read Music Volume 1 + Folding Music Stand)

Essential Elements Book 1 ($15)

Sound Innovations Book 1 ($15)

Strings Basic Book 1 ($15)

I Can Read Music Volume 1 ($15)

Suzuki Book 1 (prices vary)

Folding Music Stand ($20)

Everest Shoulder Rest ($17, black)

Everest Shoulder Rest ($19, indicate color in notes section at end: red; orange; green; blue; purple; hot pink; light pink; silver)

Kun Shoulder Rest ($28)

Snark Clip-onTuner ($15)

Korg TM-60 ($20)

Intelli IMT-301 ($30)

Set of Dominant or Helicore Strings (prices vary depending on instrument and size, card will be charged accordingly)

Primary Contact First Name*

Primary Contact Last Name*

Alternate Contact First Name

Alternate Contact Last Name

Country*

Address Line 1*

Address Line 2

City*

State or Province*

ZIP or Postal Code*

Primary phone*

Alternate phone

Email*

License Number and issuing state*

Leave us a note

I agree to the rental terms and conditions outlined in this contract. I agree to give a timely update to Amadeus Strings whenever contact, instrument, or payment information changes*

I authorize Amadeus Strings to charge the initial payment consisting of three month's rental fee plus any selected accessories or packages (if applicable) to the card provided upon receipt of this contract form.*

Electronic Signature*

Who referred you to Amadeus Strings?

NOTE: In order to complete your rental agreement we need you to provide a valid payment method. Please call 845-486-7617 or provide your information to the associate helping you in the shop.*