Instrument Purchase Scheme Form

---

View the full Cumbria County Council Privacy Policy

Instrument Purchase Scheme

• Student Details

• Student Name*
  First Last
• Date of Birth*
  Date Format: DD slash MM slash YYYY
• School*
• Instrumental Teacher Name*

• Your Contact Details

• Parent / Carer Name*
  Prefix Dr.MissMr.Mrs.Ms.Prof.Rev. First Last
• Home Address*
  Address 1 Address 2 Town County Post Code
• Email*
  Enter Email Confirm Email
• Contact Phone Number*

• Instrument Details

• Instrument Required*
  GuitarViolinViolaCelloDouble BassFluteClarinetOboeSoprano SaxophoneAlto SaxophoneTenor SaxophoneBass ClarinetBassoonCornetTrumpetFlugel HornFrench HornTenor HornTromboneBaritoneEuphoniumTuba
• Model Number
• Chosen Supplier*
• Supplier Website Address
• Supplier Shop Address
• Instrument List Price*
  You will be invoiced for the cost of the instrument without VAT. We will add an administration fee of £18.50 to your final invoice.

• Payment

• You will be invoiced for the cost of the instrument without VAT plus the £18.50 admin fee. PAY BY CHEQUE: payable to 'Cumbria County Council' or PAY ONLINE: www.cumbria.gov.uk/payonline/default.asp
• Contact Permission*
  We may occasionally want to get in touch by email to let you know about events organised by Cumbria Music Hub.
  • Yes please, I'd like to hear about Cumbria Music Hub events
  • No thanks

Having problems? Download the  Booking Form and email to

---