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NY Quality Strings Rental & Accessories Order Form
Customer Information
Important: Enter a valid e-mail address. Receipts will be sent to this address.
*E-Mail:
*Parent/Guardian/Adult Name
Child`s Name
Child`s School
Music Teacher Name
Music Teacher Contact Number
How Did You Find Us?
Choose your instrument
*Instrument
*Instrument Level
Standard Quality Advanced 
*Violin Size
*Viola Size
*Cello Size
Choose your Violin Rental Term and Insurance Option
Standard Violin
Quality Violin
Advanced Violin
Choose your Viola Rental Term and Insurance Option
Standard Viola
Quality Viola
Advanced Viola
Choose your Cello Rental Term and Insurance Option
Standard Cello
Quality Cello
Advanced Cello
Delivery/Pick-up Option:
Delivery Preference
Child`s School Schedule an Appointment Delivery to Address 
Delivery by date
*Delivery Address
Accessories for Purchase
Shoulder Rests
Music Stand
Music Books
Cello Endpin Holder
Other Accessories:
Sub Total:
NY State Tax
Grand Total
Billing Information
*First Name:Same name as on your card
Middle Initial:
*Last Name:
*Address Line 1:
Address Line 2:Apt. or Suite No.
*City:
*State:
Country
*Postal Code:
*Phone:
Payment Information
*Card Number:No dashes or spaces please
*Expiration Month:From your card
*Expiration Year:From your card
*Card Brand:
*CVV code3 or 4 digit security code
*I understand and hereby agree to electronically sign the NY Quality Strings Terms and Conditions
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