Instrument Loan Request Form
The Music Department of the Bergenfield Public Schools has a limited number of school-owned instruments available for loan to students. District-owned instruments will be available to those pupils for whom the purchase of a musical instrument would impose a difficult financial burden. A list of music stores with rent-to-own programs is provided by the instrumental music faculty.

School-owned instruments being offered in the fall 2021 to students in grades 4-12. Completion of this form does not guarantee the instrument will be available. School instruments will be distributed until the supply is exhausted on a first-come, first-served basis. Instruments must be returned at the end of the school unless other arrangements are made with the instrumental music faculty.
Student First Name *
Student Last Name *
Student ID Number *
Student Grade *
Current School Attending *
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