Progress 1. Introduction | 2. Submit Application | 3. Select School | 4. Select Instrument | 5. Finalize Order | 6. Confirmation

.

NOTE: In the event this transmission is interrupted, please call MMC at 765/284-4481 to provide info.

All personal information is for internal use only. We value your privacy, and do not
share your personal information with ANY third party! * indicates required field.

Rent-to-Own Application

Student Info
* First Name:

* Last Name:
* School System:

NOTE: If your school is not listed,
call 765/284-4481 to verify service availability.
Our Rent-to-Own Program is only available to schools we service!
Applicant Info
(person responsible for rental payments):
* First Name:

* Last Name:
* Your Email Address
If you are a PayPal member, please use
your PayPal email address of record:

.
* Street Address:
* City:
* State:
* Zip:

   Phone Information (at least ONE number required)

* Primary Phone:

   Secondary Phone:

   Additional Information

   Your SSN:

* Employer:

* Work Phone:

* Name of relative/friend
(not living with you):

* Relative's Phone:
Co-Applicant Information (optional)
Spouse or Co-Applicant:
Co_Applicant Address
(if different than Applicant):
City:
State:
Zip:

Relationship:

Spouse

Friend

Co-Applicant's SSN:

Co-Applicant's Employer:

Co-Applicant's Work Phone:
Any message or additional info:

By clicking the Submit button below you affirm that you
have read and agree to abide by our Rental Agreement.
In the next section, you will select the instrument(s) you want to rent.