E-mail *

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

Brand name of Piano (if available)

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)

Electronic

Cell Phone *

Is the piano in a different location?

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

Select piano from drop down list *

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

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

Address *

Year of manufacture - if available

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

Date

City, State, Zip *

Name *

Phone *

Grand Piano

NOTE Piano will not be considered without pictures.

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

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