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Tameside Music Service

INSTRUMENTAL LOAN


PUPIL INFORMATION
Pupil Name
Date of Birth / /
Gender
School
School Year
SEND/Medical Needs
Ethnicity
PARENT/CARER INFORMATION
Name
Title
Relationship to child
Address line 1
Address line 2
Town
City
County
Postcode
Home Tel
Mobile
Email Address
Emergency Contact Name
Emergency Contact number
  I am currently receiving instrumental lessons through Tameside Music Service
  I currently loan a Tameside Music Service Instrument:
Instrument Serial Number (if applicable)
Type of instrument you wish to loan
 
I agree to pay the loan charge of £45.00
I agree to pay the loan charge of £22.50 as pupil is in receipt of FSM as an Education Welfare Benefit
Pupil is a looked after child
Pupil is Super Seven 7
Pupil is Super Seven plus

I have read, understood and agreed to the terms and conditions including the cancellation policy.

Play Achieve Inspire - Grater Manchester Music Hub