John Keal Music Company Instrument Repair Estimate Request Form
Print out this form, place it in the instrument and leave it with your Band/Orchestra teacher at school. Our school representative will pick up the instrument on their next scheduled day*.
When you hit the submit button below, a copy of this form will be sent to our office to alert the sales representative that an instrument repair is waiting to be picked up at the school for an estimate.

*Our office will email you with the next scheduled pick up date for your school. Pick ups are weekly/bi-weekly/monthly depending on your school.

We will call you with the phone # provided with the repair estimate.
No work will be performed without your approval first.
If you decide not to have the work done, we will send the instrument back to school free of charge!
Pre-payment is required on all approved repairs.

Best phone#(s) to contact you with the estimate. Please include area code. *
Your answer
Email Address *
Your answer
Students Full Name *
Your answer
School District & Name (PLEASE no abbreviations) *
Your answer
Band or Orchestra Teacher's Name *
Your answer
Instrument *
Your answer
Brand name of instrument (if known)
Your answer
Please describe the problem/work requested *
Your answer
Parents Full Name *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
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