Tag #____ (will be given by CDSD personnel)

    Mailing Information (Checks for sold instruments will be mailed to this Name & Address)

    Name ___________________________________________        

    Address      _______________________________




    Contact Information on Day of Sale

    How would you like to be notified if instrument sold or not? (1st, 2nd, 3rd)

    ______       Phone Call # (____)  ______________________________

    ______       Text # (____) ____________________________________

    ______       Email:        ______________________________________

    Type of Instrument ____________________     Make ______________________


    Serial # _____________________           Asking Price ** $_____________


    Accessories ___________________________________________________


    Special Comments ______________________________________________

    ** Note: List the exact price you want listed for sale. The Central Dauphin School District Orchestras will deduct 10% from this price as a consignment fee if the instrument is sold. The Central Dauphin School District Orchestras will not change/negotiate price during the sale.

    I, the contributor, understand that if the instrument identified above is sold during the sale, the Central Dauphin School District Orchestras will issue a check to be mailed approximately three weeks after the sale in the amount listed less less 10%. All transactions are final. Unsold instruments must be picked up, between 12:00 pm and 1:00 pm Saturday unless you wish to donate the instrument to the CDSD Music Program.

    If this instrument does NOT sell between 9 am-12 pm, do you wish to donate this instrument to the Central Dauphin School District Music Program?                               ___ Yes   ___No

    (You will be mailed a letter confirming charitable contributions receipt for tax purposes.)


    Contributor’s Signature ____________________________  Date ___________