2018-2019 Accident Report
Students will fill out form any time an instrument accident occurs in the classroom.
Email address *
First Name *
Your answer
Last Name *
Your answer
Grade Level *
Required
Period *
Required
Did you drop your instrument? *
Required
Did a string pop? *
Required
What is broken? *
Required
In your own words, what exactly occurred to break the instrument? *
Your answer
You are responsible for having all supplies and instruments in class. By checking the box below, you are agreeing to get the repairs/strings needed as soon as possible and complete any work given in the mean time should you not be given a loaner instrument from the shop. *
A copy of your responses will be emailed to the address you provided.
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