2022-23 Wilson Middle School Band Instrument Usage and Maintenance Fee Agreement
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Email *
Student FIRST name *
Student LAST name *
Parent/guardian FIRST name *
Parent/guardian LAST name *
Street address  (for example 310 Elm St.) *
City* *
Zip Code* *
Phone Number  (this format: 123-456-7890) *
Instrument you are using *
Serial Number (found on outside of the case) - if you know it.
2nd Instrument Serial number (if applicable) - if you know it.
Replacement cost *
Accessories- please click on any item included with the instrument *
Required
I understand I will need to pay an $85 instrument usage fee unless approved for another amount and will pay this fee by SEPTEMBER 30th.  *
Official Agreement
The Plano Independent School District provides certain musical instruments.  A non-refundable $85.00 instrument maintenance fee is charged to maintain the normal wear and use of this instrument for the school year.  Students who use multiple instruments in the normal course of instruction will pay a single fee.

Parents agree to return the instrument to the director at the end of the semester or academic year, or upon director request, in the same condition it was issued to the student, less reasonable wear.  The maintenance fee does not cover major damage or loss.  Damage beyond normal wear or loss of the instrument while in the student’s possession becomes the responsibility of the parents to pay for repairs or replacement.

If the instrument is to be taken home, the Plano ISD encourages parents to cover these instruments on their homeowners’ insurance policy if possible.  Alternative insurance policies are also available at a nominal annual fee.  Please see your director if interested.

Please sign below to state that you have read and agree to the terms of this contract.
Electronic Signature Authorization *
I agree that the electronic digitized signatures I apply on this document are representations of my signature and are legally valid and binding as if I had signed the document with ink on paper in accordance with the Uniform Electronic Transactions Act (UETA) and the Electronic Signatures in Global and National Commerce Act (E-SIGN) of 2000.
Parent/Guardian Signature *
I agree to all policies stated. Type your first and last name here. This item will be time stamped when you submit.
RYCOR LINK (to pay fee)
https://www.studentquickpay.com/PISD 
A copy of your responses will be emailed to the address you provided.
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