INSTRUMENT HIRE

Please note: you must complete this form even if you have previously completed an online instrument hire form.

In order for you to complete this application form you must have read the following documents

Regulations and Conditions
Data Protection policy
Privacy Notice

Instrument Hire Application

Parent/Carer Details

Title

Other title

If title is 'other' then please enter title here.

First name *

Surname *

West Sussex Music Account Number

Address *

Preferred phone number *

Email address *

A copy of your form submission will be sent to this email address.

Student Details

First name *

Surname *

Gender * Male Female

Date of birth *

DD/MM/YYYY.

School currently attended *

Town of current school *

Does the student receive benefits related free school meals? * Yes No

Is the student currently in care? * Yes No

Musical Details

What type of instrument hire are you applying for? * A replacement instrument An instrument for new school lessons An instrument for Music Centre lessons An instrument for a whole class school programme

Instrument *

Instrument size (where applicable - seek guidance from your teacher)

Name of Teacher *

Regulation and Conditions

Conditions of hire * Tick to confirm agreement

Data Protection

Please tick to confirm that you have read our Data Protection Policy (GDPR 2018) * I agree to the Data Protection policy.

Privacy Notice

This notice explains why we collect personal information about our customers and how we use it. Please confirm that you have read our privacy notice and understand how we will use your personal information. * I have read the Privacy Notice.

Declaration

You must be over 18 to apply for our services and you must have legal responsibility for the child named in this application. * I confirm that I am the parent/carer of the child named in this application and that I am over 18 years of age.

IMPORTANT: To avoid our messages going in to your junk folder please add music@westsussexmusic.co.uk to your email address book.

Enter the security text *

West Sussex Music
The College of Richard Collyer
Hurst Road
Horsham
West Sussex, RH12 2EJ

A company limited by guarantee registered in England and Wales
Company number: 8524556 | Charity number: 1152703

Tel: 08452 082 182
Email: music@westsussexmusic.co.uk

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