Instrument Repair Request
* Required
Student Name
*
Your answer
Class Period
*
Choose
1 Period
2 Period
3 Period
4 Period
5 Period
6 Period
Instrument
*
Choose
Flute
Clarinet
Bass Clarinet
Alto Saxophone
Tenor Saxophone
Baritone Saxophone
Trumpet
F Horn
Trombone
Baritone
Tuba
Percussion
Instrument Locker Number / Instrument Location
*
Your answer
Where did you get your instrument?
*
Choose
Music & Arts (formerly Draisen-Edwards)
Chick Music
Personal instrument / Purchased elsewhere
School Instrument
In your own words, what problem are you having? For example, which notes don't play, is a certain valve always getting stuck, etc.
*
Your answer
Did something happen that might have caused the issue? This helps us troubleshoot the problem.
*
Yes
No
Not sure
If you answered yes, explain what happened:
Your answer
Submit
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