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Loaner Lessons Application

Send no money now!  
Bring payment with you when you pick up the instrument.
Lessons begin the week after pick-up.

Fill out this form, then press the Submit button, or print and mail to:
Lucille Reilly, P.O. Box 7338, Denver, CO  80207

Name:
Street:
City:    State:   Zip +4  -
Phone: day: ()     eve: ()     
cell: ()
  email:

Loaner instrument I wish to try: hammered dulcimer    autoharp

First choice:      day         time

Second choice: day         time

       

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