Fairfield Technology Ltd

2 Orchard Close, Spencers Wood, Reading RG7 1EJ

0118-988 5566 or 07804-651 142  www.saxhire.co.uk  Saxhire@googlemail.com

Application Procedure

Personal Details:

Name of Parent:

Address:

Postcode

Tel Home:

Tel Work:

Tel Mobile:

School:

Name of child:

Name of instrument teacher:

Instrument: New Yamaha YCL-250sUK clarinet including case, 2 reeds, cleaning cloths, mouthpiece patch and cork grease.

Supplier: Fairfield Technology Ltd (0118-988 5566) 2 Orchard Close, Spencers Wood, Reading RG7 1EJ.  0118-988 5566 Saxhire@googlemail.com

Instrument price Excluding VAT: 252.17 + £7.83 postage = £260

VAT: £39

Total Due: £ 299

Parents Declaration:

I declare that to the best of my knowledge the information given above is correct and I agree to comply with the conditions of the Assisted Instrument Purchase Scheme.

Parents signature:                                                                           Date: