On-Approval Form On-Approval Form Date(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Name(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone(Required)**must include area code**Email(Required) Credit Card(Required) American ExpressDiscoverMasterCardVisaJCBMaestroSupported Credit Cards: American Express, Discover, MasterCard, Visa, JCB, Maestro Card Number Expiration Date Month Month010203040506070809101112 Year Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Security Code Cardholder Name The card will not be billed unless the instrument returns with damage or the instrument(s) are purchased.I HEREBY ACKNOWLEDGE RECEIPT OF THE FOLLOWING MERCHANDISE TO BE TAKEN FROM GUARNERI HOUSE ON TRIAL, AND I ACCEPT FULL LIABILITY IN CASE OF ACCIDENTAL SHIPPING LOSS, DAMAGE, FIRE, THEFT, VANDALISM, ETC.(Required) Agree Value of Instrument(Required) Serial Number(Required) Description(Required) Known Damage(Required) Add another instrument click me! Value of Instrument(Required) Serial Number(Required) Description(Required) Known Damage(Required) IF NOT PURCHASED, THE MERCHANDISE MUST BE RETURNED IN THE SAME CONDITION AS WAS RECEIVED WITH IN 10 DAYS OF THE DATE ABOVE. IF SHIPPING TO GUARNERI HOUSE, USE UPS OR FEDEX. ARE ITEMS MUST BE INSURED FOR FULL VALUE, AND TRACKING INFORMATION SUPPLIED TO GUARNERI HOUSE.(Required) I acknowledge Type Name of Responsible Party(Required) Student's Name & Number (IF APPLICABLE): Teacher's Name & Number (IF APPLICABLE): CAPTCHA Δ