School Instrument Rental Request Form
Parents and Students.  Please complete this form if your child needs to use a school instrument.  The use of a School Instrument requires a $75.00 fee. If your child plays percussion instruments, there will be a fee of $10.00. If you are experiencing a financial hardship, the fee may be reduced or waived. This form does not guarantee that you will receive an instrument.  This lets Mr. Brill know that you would like to checkout an instrument from the school.  Eagle Valley Middle School has a small, but limited supply of instruments at a first come first serve basis. Large or less common instruments are available to rent from the school.  If you are experiencing a financial hardship, the fee may be reduced or waived.

Please complete this form by Tuesday August 22nd to be considered for a school instrument.
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Email *
Parent/Guardian Name: *
Parent/Guardian Phone Number: *
Students First Name: *
Students Last Name: *
Students Grade: *
Music group the student will be participating in this year: *
Instrument Requested:                                                       *
Required
Please Select One: *
Will you child walk, ride the bus, or get dropped off/picked up at school? (This will help me know which size instrument to check out as some instruments have different sizes available) *
Do you have additional questions?
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