Fill out the form below and submit proof of enrollment to or

PROBIRT
PO Box 28
Annville, PA 17003

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FREE Band Instrument Repair Student Subscriptions

If you are currently enrolled in the band instrument repair program of a recognized and accredited band instrument repair school, you are eligible to receive one free annual subscription. To take advantage of this offer you must satisfactorily fill out the form below and provide proof of enrollment by submitting one of the following documents to PROBIRT:

- Proof of Enrollment Certificate
- A copy of current tuition bill or receipt
- A copy of current class enrollment or registration form
- A copy of current class schedule

When both the questionaire and proof of enrollment are received and approved, the student will have Technician member level access to the site.

All fields except "Additional Comments" are required.

FIRST NAME
LAST NAME
ADDRESS
CITY
STATE/PROVINCE
COUNTRY
ZIP/POSTAL CODE
EMAIL
PHONE
CHOOSE A USERNAME
CHOOSE A PASSWORD
BIR SCHOOL	Choose School Badger State Repair Keyano College MN State College - SE Technical Renton Technical College Western Iowa Tech Other
If "Other" BIR School
EXPECTED DATE OF GRADUATION
1. Please give us a little background about yourself in regards to schooling, music, shop courses, etc.
2. Why did you select band instrument repair as a career?
3. How far along are you in your schoolingl?
4. Tell us a little about your experiences so far at band instrument repair school. (Hint: This is THE most important question of the seven. Be sure to give go into detail and give examples.)
5. Where do the horns you work on at school come from? Customers? Reusable junk pile? Donated?
6. How many students are in your class and what is their average age?
7. What can PROBIRT do that would help you the most with your band instrument repair education?
Additional Comments:
I agree to the terms of use of PROBIRT and the terms of submitting this form.