Music/drama request - Orchestral Set

Complete this application if you wish to request an Orchestral Set for your society. Please note we need at least 4 weeks notice to supply a set.

Name of society.  *
Membership number (14 digits)  *
Your name  *
Home address   *
Landline telephone number including STD/dialling code. Do not include spaces.
Mobile phone number.
Email address.  *
Select the library collection branch.  *
Title/Work  *
Editions, etc. Please leave blank unless a specific edition or arrangement is required.
Date required from. We require 4 weeks advance notice.  *
Date required to.  *
Date of performance.
Orchestral sets are supplied in pre-determined numbers of parts.
Any additional information.
As organiser or nominee for the above society, I undertake to return to the Library the performance set supplied for the above group by the date specified, or replace/pay for lost or damaged copies.  *
I agree
 Please leave the remaining boxes blank and click "Finish" below.

FOR STAFF USE ONLY - amount to be paid:

For staff use only:

Full Score_____   Piano Conductor_____   Miniature Score_____

Violin 1______   Violin2______   Viola_____   Cello______          Bass_____

Flute_____  _     Piccolo_____  Oboe_____    Cor Anglais_____  Clarinet_____

Bass Clarinet_____  Bassoon_____  Contra Bassoon_____

Horn_____  Trumpet_____  Cornet_____  Trombone_____ Tuba_____

Timpani_____   Percusssion____________________________________________________

Harp_____  Organ_____  Sax_____  Other__________________________________________________
Please return the set by:


date  __________________

signature of co-ordinator  ______________________________________

signature of staff  ____________________________________________

date  ______________________

signature of co-ordinator  _________________________________________

signature of staff  ________________________________________________
Return paperwork and set to CLH - complete/incomplete?

If the set is returned incomplete, please specify below the number of parts missing and give detail of return/replacement timeframe:
* indicates that you must supply an answer

Thank you - we will be in touch.

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