Orchestra Rental Agreement
Kniskern Music House, Inc.
Teacher recommended!!

Please call me anytime if you prefer to fill out your contract over phone!  
Kathleen Kniskern
Please choose your instrument:
$12.95 initial payment covers your violin, viola, or cello rental 'til January, 2019
Please call  for bass availability
1/4 Cello
12" Viola
1/4 Violin
1/2 Cello
13" Viola
1/2 Violin
3/4 Cello
3/4 Violin
14" Viola
After January 01, 2019 per month charge:
Violin & viola $26.95 Rental + $4.00 M&R + NYS Tax $2.17 = $33.12 per month

All cellos $34.95 rental + $5.00 M&R + $2.80 NYS tax = $42.75 per month
Please fill out your information
(*) = Required Fields
*Father/Guardian Name
*Mother/Guardian Name
*Street Address
*Child's Full Name
Employer Information:
*Father/Guardian Employer
*Mother/Guardian Employer
*School Name (Shenendehowa,  or  Saratoga Schools
Check One
Please deliver instrument to school
I want to pick up instrument at Kniskern Music House
(you will be contacted by Kathleen Kniskern for
your child's personal fitting)
Credit Card Information
*Exp. Date
*Security Code
*Name on card
Master Card
*Card Number
Kniskern Music House Instrument Rental Terms & Conditions
I have read,understand, and agree to the Kniskern
Music House Instrument rental terms & condtions
*Please Initial to agree
Please verify your information
before submitting

Thank you!
Kathleen Kniskern