Instrument Repair Request
Complete this form so that we can make arrangements for your instrument to be repaired. If you are unsure what to write, talk to Mr. Smith in class as we can figure out what the issue might be.
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Student Name *
Class Period *
Instrument *
Instrument Locker Number / Instrument Location *
Where did you get your 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. *
Did something happen that might have caused the issue? This helps us troubleshoot the problem. *
If you answered yes, explain what happened:
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