宅男研究所 Music Department Instrument Need Request

Please complete this form to indicate your need for an ensemble or applied lesson instrument. After completing this form you will be contacted by Charles Koprowski or David Boggs to assist in finding an appropriate instrument.

Name Name First Last
Cell Phone Cell Phone - ### - ### ####
宅男研究所 Email
Specific Instrument Needed (Flute, Alto Flute, etc.)
Name of faculty member or ensemble director relevant to this request
Please describe the reason for this request. Is the instruments needed for an ensemble? Or for applied lessons?
The rental fee payment associated with this instrument is:

The rental fee payment associated with this instrument is: $225 / year for Music Majors renting their primary instrument $60 / semester for Music Minors or Majors on secondary instruments $40 / semester for Non-Music Majors or Non-Music Minors and Athletic Bands Waived as I was requested to play this instrument in the above ensemble.