RIOT RI Gear Loan Form
Practicing community care at home by way of social distancing? we know it's hard! and we want to open our gear loan program to provide music access during this time. Let the music fill your soul and share it with others!

We are offering music kits to all girls, women, trans and nonbinary youth and adults that will include:

- An electric guitar or bass (we are out of keyboards and have a very limited number of drum kits available at this time)
- 1/4 cable to get you plugged in
- Practice booklet
- a couple of picks

**We are waiving our deposit fee to those whose income has been affected by COVID-19, if you have the ability to pay we ask that you self assess in how much you can contribute to help us fund music accessibility to others Regular deposit fee $30. No one turned away for lack of funds!

Once your form has been submitted, a staff member will contact you to arrange pick up/drop off.

Contact denise@girlsrockri.org or rikki@girlsrockri.org.with any questions

(For more information on how to access essential services and needs please visit our website with links to community resources)
Email address *
Full Name
Your answer
Pronouns ex. She/Her/Hers, They/Them/Their
Your answer
Age
Your answer
Phone Number
Your answer
E-mail
Your answer
Address
Your answer
Have you ever taken any programming at RIOT RI aka Girls Rock! Rhode Island?
If yes, which program have you taken part of?
Which kit would you prefer?
I already have a guitar/bass can I take out an amp?
Getting the music to ya
Has your personal/family income been affected by COVID-19 and would like to have the Regular deposit fee $30 waived?
Submit
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