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POSA Instrumentarium Loan Application Form
Name_____________________________________________________ Address___________________________________________________ Home phone_________________ Work Phone__________________ School/Organization_______________________________________ Dates of loan: 1st choice_____________________________________________________ 2nd choice_____________________________________________________ Experience: Please describe your music/education background, including Orff-Schulwerk training and workshops: Proposal: Describe your intended use for the instrumentarium. Include age levels and number of students served and briefly summarize your curriculum goals (use more space if needed). Storage: Please explain how the instruments will be stored when not in use. Applicant signature_______________________________________________ Date_______ Received by POSA Board_____________________________________________________ Action Taken_____________________________________________________ Date instruments will be picked up by applicant _______ Date instruments will be returned by applicant ______
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