Instrument Purchase Form

Please send us your details using the online form below.

You will be invoiced for the cost of the instrument without VAT plus the £18.50 admin fee.

PAY ONLINE: www.cumbria.gov.uk/payonline/default.asp or

PAY BY CHEQUE: payable to ‘Cumbria County Council’ (Post to: Cumberland and Westmorland & Furness Music Services, St Michael’s Centre, Station Road, Workington CA14 2UY)

"*" indicates required fields

Student Details

Name*

First Last

Date of Birth*

School*

Instrumental Teacher Name*

Your Contact Details

Parent / Carer Name*

Prefix First Last

Home Address*

Address 1 Address 2 Town County Post Code

Phone*

Mobile

Email*

Enter Email Confirm Email

Relationship to Student*

Instrument Details

Instrument Required

Model Number

Chosen Supplier

Supplier Website Address

Supplier Shop Address

Instrument List Price

Payment

You will be invoiced for the cost of the instrument without VAT plus the £18.50 admin fee. PAY ONLINE: www.cumbria.gov.uk/payonline/default.asp or PAY BY CHEQUE: payable to 'Cumbria County Council' (Post to: Cumberland and Westmorland & Furness Music Services, St Michael’s Centre, Station Road, Workington CA14 2UY)

Contact Permission*

We may occasionally want to get in touch by email to let you know about events organised by Cumbria Music Hub.

Yes please, I'd like to hear about Cumbria Music Hub events

No thanks

View the full Cumbria County Council Privacy Policy

Having problems? Download the Booking Form and email to jayne.bowman@cumbria.gov.uk

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