Orchestra Rental Agreement
Kniskern Music House, Inc.
518-852-9008
                                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,  cello, Bass rental 'til January, 2018
1/4 Violin
12" Viola
13" Viola
1/2 Violin
14" Viola
3/4 Violin
4/4 Violin
1/4 Cello
1/2 Cello
3/4 Cello
After January 01, 2018
All Violins $
34.95 rental + $5.00 M&R +$2.80 nys tax = $42.75 per month
All Violas
$34.95 + $5.00 M&R + $2.80 nys tax = $42.75 per month
All Cellos $34.95 rental + $5.00 M&R +$2.80 nys tax = $42.75per month
All Bass $49.95 Rental + $8.00 M&R
Please fill out your information
(*) = Required Fields
*Phone
*Father/Guardian Name
*Mother/Guardian Name
*Phone
*Street Address
*Zip
*State
*City
*Child's Full Name
*Email
Employer Information:
*Father/Guardian Employer
*Mother/Guardian Employer
*Address
*Address
*Phone
*Phone
*School Name
(Shenendehowa or  Saratoga)
Schools Only)
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
Visa
Master Card
American Express
Discover
*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