MONTHLY RENTAL DOWN PAYMENT
(Amount you will pay today for either your month to month or school year rental) 
Rental Payment Due Today 14.90
PEACE OF MIND MAINTENANCE
(Coverage against damage, theft, & loss. No deductible.)
Required POM Maintenance (Yuma) $5 /Month 5.00
ACCESSORIES
(Teacher recommended supplies needed to play and maintain your instrument)
Required Cleaning & Sanitization Deposit 17.00
DELIVERY
In Store at Fretworks Music 0.00
PERSONAL INFORMATION



CREDIT CARD PAYMENT INFORMATION
(no spaces)

SUBTOTAL
(Amount you will pay today for rental & accessories)
Rental Down Payment 14.90
Maintenance Down Payment 5.00
Total Including Accessories
RECURRING MONTHLY RENTAL PAYMENT
(Amount charged automatically on your next payment due date) 
Recurring Monthly Rental Payment 14.90
Recurring Monthly Maintenance Payment 5.00
TERMS & CONDITIONS
You must agree before submitting.
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