Ken Stanton Music -- Band and Orchestra Instrument Rental Application

Online Rental Application

Our online application is secure and confidential. Please note that rental instrument availability is limited - please check ahead with the store location where you'd like to pick up your rental.

View our rental rates.

All applicants must be at least 21 years of age - Applications may be subject to credit approval.
Rentals are only available to customers residing in the state of Georgia. The person filling out the rental application must be present to sign the rental agreement when picking up the instrument and must show his or her valid Georgia drivers license for verification.

Unless otherwise indicated, all fields under "Applicant Information" are required.

Instrument

Our instruments are graded based on appearance -
all used instruments have been thoroughly cleaned and adjusted by our on-site repair staff.

Instrument:

Condition:

Size (strings only):

Applicant Information

Legal Name:

Street:

City:

State:
GA

Zipcode:

Home/Primary Phone Number:

Cell Phone Number:

Email Address: (optional)

Georgia Drivers License Number:

Social Security Number: (xxx-xx-xxxx)

Name of Nearest Relative: (not living with you)

Relation

Relative's Phone Number

Employment

Employer Name:

Employer Address:

City:

State:

Zipcode:

Employer Phone Number:

Position/Title:

Length of Employment:

Years:

Months:

Student Information

Students Name:

Students School:

Students Grade:

Credit Reference

EZ Rent:

The EZ Rent option allows renters to secure their credit with us by providing major credit card information as an alternative to having a credit report run. All EZ Rent accounts will be set up as Autopay and monthly charges will be taken from that card.

EZ rent is only available for the following previously rented instruments:
Closed Hole Flutes, Plastic Clarinets, Trumpets, Trombones, Percussion Kits, Violins, and Violas.

Your initial payment and monthly payments will be run on this credit card.
Ken Stanton Music, Inc. is not responsible for any bank fees or overdraft fees which occur from the use of this card.

Card Type:

Card Number:

Expiration Date:

Credit Report:

By checking this box I am authorizing Ken Stanton Music, Inc. to obtain a copy of my personal credit history.

"Peace of Mind" Maintenance Option

The Peace of Mind Maintenance Option provides repair and replacement coverage on your rental instrument for a small monthly fee. As most instruments will need regular maintenance this option is highly recommended.

The POM is only offered when the agreement is initiated and cannot be added later. If POM is not purchased, Lessee will be responsible for all maintenance and service on the leased instrument at Lessee's expense, and will be responsible for loss, theft, damage in excess of normal wear and tear, or destruction of the instrument, at the cost ranging from a minimum repair fee ranging from $85 - $150 (dependent on instrument class) up to a maximum of the instrument's Fair Market Value. If POM is not purchased, there will be a minimum repair fee ranging between $85 - $150 (dependent upon instrument class) up to a maximum of the instrument's Fair Market Value to refurbish the instrument if returned. Lessee is not required to purchase the Peace of Mind Plan, and it may not be available on all types of instruments.

Peace of Mind Maintenance Coverage - Monthly Fees
$6.99 : Closed hole flutes, plastic clarinets, trumpets, trombones, drums, bells, violins, and violas
$7.99 : Open hole flutes, wood clarinets, alto Saxophones, oboes, single French horns, euphoniums, and 4/4 cellos
$9.99 : Tenor Saxophones, and bass clarinets
$10.99 : Double French horns, and string basses

Yes, I wish to add the Peace of Mind Coverage to my rental
No, I do not wish to add the Peace of Mind Coverage to my rental, and I agree to be responsible for any repairs or damages incurred, including the refurbishment fee mentioned above.

Autopay (optional)

For credit report options: by default we will send you statements for your monthly rental payments, and you can pay by mailing in checks, visiting one of our main locations, or calling us. However, for your convenience you can authorize us to charge your monthly rental payment to the card you provide.

By checking this box I am authorizing Ken Stanton Music, Inc. to deduct monthly payments from the credit card provided below. Ken Stanton Music, Inc. is not responsible for any bank fees or overdraft fees which occur from the use of this card.