Grand Piano

E-mail *

Name

Date

For Grand: entire piano with lid open, picture 2 of 2 different photos.

Date requirement for moving the piano

My piano may be donated to other than a nonprofit organization. *

I agree

I do not agree (nonprofit only)

Zip code *

Name

For Grand: entire piano with lid open, picture 1 of 2 different photos.

Is the piano in a different location?

Name

Address *

Year of manufacture - if available

City, State *

Brand name of Piano (if available)

All required sections must be filled out or form cannot be submitted.

Select piano from drop down list *

Name

Name *

List general condition and any problems with the piano such as sticky keys, dropped pedal, etc. If no problems exist type "none". *

Picture of keyboard with name-plate (above middle C ) *

Recipients will pay for moving costs. Movers will need to know how many stairs from the piano to the curb. *

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Having trouble with this form? Contact us at piano@pianoadoptionprogram.org