Affiliate Instrument & Supplies Order Form

Affiliate Instrument & Supplies Order Form
Use the form below to request instruments, program documents, rental brochures & shipping supplies.
Orders are parsed & emailed directly to Kevin Elliott at the VIR Seminole Facility.
To order repair & replacement parts, please use our Parts Order Form.

Affiliate Number	Store Name	Email Address

Request Instruments

QTY	Condition	Instrument	Type

Request Program Documents & Materials

QTY	Document Type

Request UPS Return Shipping Supplies

QTY	Weight

Special Notes & Instructions

Veritas Instrument Rental is a proud member of the VH1 Save the Music Foundation,
The National Association of Professional Band Instrument Repair Technicians, The National Association of School Music Dealers
and The National Association of Music Merchants