Music Instrument Repair Request

VENDOR: Music & Arts (Guitar Center Stores, Inc.)

School/Teacher Information
School Name Teacher Name

School Pick-up Name Teacher Phone

School Drop-off Name Teacher Email

Repair Request Date Sent (MM/DD/YY)

Instrument Make Model

Serial Number Repair Information

List Requested Repairs

Repair Needed Due To:

Normal Wear Accident Student Neglect

Other (explain):

Print a separate Repair Request form for each instrument/equipment and place a visible copy of the form to the case of the instrument/
equipment.
Label the case of the instrument/equipment with the school name.
If you have any questions call (703) 999-6931 and ask for Kerry Nelson, knelson@musicarts.com.
Make a Master Copy for yourself. Fill out the top Teacher Section, Repair Request Section, and Repair Needed Section.
For your records, save a copy of each repair form for each instrument/equipment repair.
Remember to give each form a unique name when saving to your computer, in order to save the repair information for each repair.

To be completed by Music & Arts (Guitar Center Stores, Inc.):

All work completed

Age

Parts not available

Beyond economical repair

Cannot service this brand

Other (explain):

Date Returned Signature by school official of returned equipment

Date Returned (MM/DD/YY)

Band Teachers: Use this form for all double reeds, contra alto clarinets, contra bass clarinets.
General Music Teachers: Use this form for all electronic repairs.

Once The Form Has Been Completed

In order for the Submit button to function, please save this completed document to your desktop or any accessible
folder or drive. You may then use the Submit button to e-mail. These instructions are visible on screen only.

IS/MUSIC-3 (12/19) Submit Button