NOTE Piano will not be considered without pictures.

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

I agree

I do not agree (nonprofit only)

E-mail *

Name *

City, State, Zip *

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 1 of 2 different photos.

Brand name of Piano (if available)

Date

Cell Phone *

Phone *

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

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. *

Is the piano in a different location?

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

Electronic

Date requirement for moving the piano

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

Select piano from drop down list *

Spinet

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