Instrument Rental Return Request

Parent's Name: Student's Name: Street Address: City / State / ZIP: Cell Phone Number: Email Address: Music Teacher: School: Instrument Type:

Where should we pick the rental up?:

	Home

	School

What date will you be finished with the rental?:

Will the student be continuing in band or orchestra when school resumes?:

	Yes

	No

	Unsure

Comments / Special Pickup Constraints / Etc:

Submit

Please note: You are NOT required to return your rental instrument over the summer. Our rental agreements are month-to-month. Most of our customers continue to practice and play their instruments over the summer for enjoyment.

By canceling your rental, you forfeit your two months of rent credit.

You may skip this form and return your rental to our retail store during business hours (map below):

Monday - Friday 2:00 PM - 6:00 PM

Saturday 10:00 AM - 2:00 PM

For your ultimate convenience, we are providing free, contactless home and school pickups and deliveries, so we can come to you!

Please fill out this form and we will be in touch to schedule a pickup day and time. Please allow up to one week for scheduling.

Your automatic payments will be suspended upon receipt of this completed form.

(608)-756-0081

Please email us for fastest response outside of business hours.

Questions? Email us!

orders@voigtmusic.com

Voigt Music Center

2152 W US Highway 14

Janesville, WI 53545

www.voigtmusic.com

orders@voigtmusic.com