Instrument Checkout Form

Submit this form to check out one or more school-owned instruments. If you are submitting a request beginning in a fall semester, do not complete this form until July 20 or later. The semester options will be updated by this date.

Submissions will be sent to the School of Music Warden at warden@ou.edu or to the applied professor in charge of the studio instrument you are checking out. If you have any questions about Instrument Checkout, contact the Warden. If you encounter any problems using the form, contact the OU School of Music webmaster Daryl Nagode at darylnagode@ou.edu.

Contact Information

First and Last Name

OU ID Number

Email address

Primary (Cell) Phone Number

Class Information

Course Name or Ensemble

Course Number (ex: MUTE 1234, MUED 1234, N/A if no course)

Instructor

Instrument Information

If you will check out more than 1 instrument, increase the number below. The form will expand so that you can enter the information for additional instruments.

Number of Instruments

This form allows you to enter information for up to 5 instruments. You will need to submit this form again for the additional instruments.

Instrument 1

Instrument

Serial Number

Make

Instrument ID Number

Does this bassoon belong to the studio fleet (checked out directly by Professor Ackmann)

Yes (checked out by Professor Ackmann)
No (checked out by the warden). If you're unsure, select No.

Does this clarinet belong to the studio fleet (checked out directly by Dr. Tirk)

Yes (checked out by Dr. Tirk)
No (checked out by the warden). If you're unsure, select No.

Mouthpiece Maker (leave blank if this doesn't apply)

Mouthpiece Number (leave blank if this doesn't apply)

Type of Ligature (leave blank if this doesn't apply)

Swab (leave blank if this doesn't apply)

Check to accept these charges on your bursar account for Instrument 1

Standard Rental Fee: $95.00
Tech or Instrument Class (MUTE 1211, 1221, 1231, 1251; MUED 3113, 4113): $51.00
Specialized Instrument for Studio/Ensemble: No Rental Fee
Other: No Rental Fee

Instrument 2

Instrument

Serial Number

Make

Instrument ID Number

Does this bassoon belong to the studio fleet (checked out directly by Professor Ackmann)

Yes (checked out by Professor Ackmann)
No (checked out by the warden). If you're unsure, select No.

Does this clarinet belong to the studio fleet (checked out directly by Dr. Tirk)

Yes (checked out by Dr. Tirk)
No (checked out by the warden). If you're unsure, select No.

Mouthpiece Maker (leave blank if this doesn't apply)

Mouthpiece Number (leave blank if this doesn't apply)

Type of Ligature (leave blank if this doesn't apply)

Swab (leave blank if this doesn't apply)

Check to accept these charges on your bursar account for Instrument 2

Standard Rental Fee: $95.00
Tech or Instrument Class (MUTE 1211, 1221, 1231, 1251; MUED 3113, 4113): $51.00
Specialized Instrument for Studio/Ensemble: No Rental Fee
Other: No Rental Fee

Instrument 3

Instrument

Serial Number

Make

Instrument ID Number

Does this bassoon belong to the studio fleet (checked out directly by Professor Ackmann)

Yes (checked out by Professor Ackmann)
No (checked out by the warden). If you're unsure, select No.

Does this clarinet belong to the studio fleet (checked out directly by Dr. Tirk)

Yes (checked out by Dr. Tirk)
No (checked out by the warden). If you're unsure, select No.

Mouthpiece Maker (leave blank if this doesn't apply)

Mouthpiece Number (leave blank if this doesn't apply)

Type of Ligature (leave blank if this doesn't apply)

Swab (leave blank if this doesn't apply)

Check to accept these charges on your bursar account for Instrument 3

Standard Rental Fee: $95.00
Tech or Instrument Class (MUTE 1211, 1221, 1231, 1251; MUED 3113, 4113): $51.00
Specialized Instrument for Studio/Ensemble: No Rental Fee
Other: No Rental Fee

Instrument 4

Instrument

Serial Number

Make

Instrument ID Number

Does this bassoon belong to the studio fleet (checked out directly by Professor Ackmann)

Yes (checked out by Professor Ackmann)
No (checked out by the warden). If you're unsure, select No.

Does this clarinet belong to the studio fleet (checked out directly by Dr. Tirk)

Yes (checked out by Dr. Tirk)
No (checked out by the warden). If you're unsure, select No.

Mouthpiece Maker (leave blank if this doesn't apply)

Mouthpiece Number (leave blank if this doesn't apply)

Type of Ligature (leave blank if this doesn't apply)

Swab (leave blank if this doesn't apply)

Check to accept these charges on your bursar account for Instrument 4

Standard Rental Fee: $95.00
Tech or Instrument Class (MUTE 1211, 1221, 1231, 1251; MUED 3113, 4113): $51.00
Specialized Instrument for Studio/Ensemble: No Rental Fee
Other: No Rental Fee

Instrument 5

Instrument

Serial Number

Make

Instrument ID Number

Does this bassoon belong to the studio fleet (checked out directly by Professor Ackmann)

Yes (checked out by Professor Ackmann)
No (checked out by the warden). If you're unsure, select No.

Does this clarinet belong to the studio fleet (checked out directly by Dr. Tirk)

Yes (checked out by Dr. Tirk)
No (checked out by the warden). If you're unsure, select No.

Mouthpiece Maker (leave blank if this doesn't apply)

Mouthpiece Number (leave blank if this doesn't apply)

Type of Ligature (leave blank if this doesn't apply)

Swab (leave blank if this doesn't apply)

Check to accept these charges on your bursar account for Instrument 5

Standard Rental Fee: $95.00
Tech or Instrument Class (MUTE 1211, 1221, 1231, 1251; MUED 3113, 4113): $51.00
Specialized Instrument for Studio/Ensemble: No Rental Fee
Other: No Rental Fee

Agreement (Read Carefully)

Please check boxes verifying that you have read the statements and agree to the terms

1. To use this equipment only for University of Oklahoma sanctioned events or classes.
2. To preserve the equipment and all accessories that I have in my possession.
3. To return the equipment and accessories to the warden in the condition that they were issued to me.
4. To be responsible for the equipment and accessories even if stolen, lost, or damaged.
5. To pay any costs that may occur from stolen, lost, or damaged instrument(s); and if I do not, my records and all future enrollments will be halted until all fees have been paid in full.
6. To accept the above fees and have my bursar account charged for usage of the equipment and all accessories.
7. To return the instrument(s) by the end of the semester (or the return date agreed upon by the warden or professor), and to pay a $25.00 service charge and $1.00 per day fine if the instrument is checked in after this date. If you need to check out the instrument for another semester, you must contact the warden or professor who checked out the instrument. If an instrument checked out by the warden is not needed for a final, it should be returned by 5:00pm the Friday of dead week. For Monday through Thursday finals, the instrument should be returned by 5:00pm the day following your final. If you have a Friday final, the instrument must be returned by 5:00pm on Friday.
8. To not switch or trade equipment unless approved by the warden or professor who checked out the instrument.

Signature

By entering your name below, you agree to all terms above.

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