Assisted Instrument Purchase Scheme Application Form

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Please complete all sections of this form and once the form has been submitted, full payment must be made to the school via your child's online payment account. We will advise you once this has been uploaded for payment. A £5 administration charge will be added to the application.

Your order cannot be placed with the supplier until payment has been processed.

To be eligible for the scheme you child must meet the following criteria:

The student must be in full time education at our school
The student must be receiving music tuition at the school
The instrument must be appropriate for the student's needs
The instrument must be portable

We cannot process orders over the summer holiday period and any requests submitted over this time will be picked up at the start of the new academic year.

The instrument will be delivered to the school and passed to your child.

Email *

Parent/Guardian Name *

Pupil's Name *

Child's Class *

Daytime Telephone Number *

Name of Retailer *

Address: *

Telephone Number: *

Website: *

Instrument Make: *

Instrument Model: *

Please enter below the cost of the instrument only (excluding VAT) *

A copy of your responses will be emailed to the address you provided.

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