Online Rental Application

Instrument Rental Application
Application to be completed in the name of the person that will be responsible for the agreement.
Name *
Date of Birth *

Month Day Year
Date
Social Security Number *
Address *

Address

Street Address Line 2

City State

Zip
Home (Rent, Own, Other) *
How Long At This Address *
Mailing Address (if different)

Address

Street Address Line 2

City State

Zip
Home Phone *
Cell Phone *
Spouse's Name
Date of Birth

Month Day Year
Date
Spouse Phone
Spouse's Address (if different)
Student's name *
Student Address (if different)
School and Teacher *
Student's T Shirt Size *
Email Address *
example@example.com
Employer *
Job Title *
Work Phone *
Employer Address *

Address

Street Address Line 2

City State

Zip
Nearest Relative (not living with you) *
Address *

Home Address

Street Address Line 2

State

Zip
Relationship *
Phone *
Relative (not living with you) *
Address *

Home Address

Street Address Line 2

State

Zip
Relationship *
Phone *
Relative or friend (not living with you) *
Address *

Home Address

Street Address Line 2

State

Zip
Relationship *
Phone *
Everything that I have stated in this application is correct to the best of my knowledge. By signing this application, I authorize Bailey Brothers Music Company to perform a credit check as part of the application process. I understand that Bailey Brothers Music Company will retain this application whether or not it is approved.
Signature *

Clear
Date *

Month Day Year
Date
Drivers License State and Number *
Bailey Brothers Music Company 4673 Hwy 280 East, Birmingham AL 35243
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Online Rental Application

Instrument Rental Application