Account Holder Name* First Last Email* Phone*Number of Payments Being Made* CommentsHave over 6 instruments to pay towards? Please submit the form below with up to 6 instruments and start again to process additional payments, or give us a call at 1-800-52-MUSIC!Student 1 Name* Student 1 Instrument* Student 1 Payment Type*Please SelectRental Payment - One TimeRental Payment - Setup AutobillRental Payment - Service and MaintenanceStudent 1 Payment Amount* Student 2 Name* Student 2 Instrument* Student 2 Payment Type*Please SelectOne Time PaymentAuto-BillService and Maintenance PaymentStudent 2 Payment Amount* Student 3 Name* Student 3 Instrument* Student 3 Payment Type*Please SelectOne Time PaymentAuto-BillService and Maintenance PaymentStudent 3 Payment Amount* Student 4 Name* Student 4 Instrument* Student 4 Payment Type*Please SelectOne Time PaymentAuto-BillService and Maintenance PaymentStudent 4 Payment Amount* Student 5 Name* Student 5 Instrument* Student 5 Payment Type*Please SelectOne Time PaymentAuto-BillService and Maintenance PaymentStudent 5 Payment Amount* Student 6 Name* Student 6 Instrument* Student 6 Payment Type*Please SelectOne Time PaymentAuto-BillService and Maintenance PaymentStudent 6 Payment Amount* Terms to ACH*If any information you provide is untrue, inaccurate, not current or incomplete, Rettig Music Inc. reserves the right to recover from you any costs incurred as a direct or indirect result of the inaccurate information. Agree Type of Bank Account* Checking Savings ACH Routing Number* ACH Account Number* CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.