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EIU Music Department Instrument Check In Form

Name Name First Last
Phone Phone - ### - ### ####
Email
Specific Instrument (Flute, Alto Flute, etc.)
Instrument Brand (Yamaha, Jupiter, Armstrong, etc.)
Instrument Model (YHR762, etc.)
Instrument Serial Number
Locker Number
Lock Combination (ex. 13-07-42)
Lock Number (found on the back of the padlock)
Instrument White Tag Number (if present)
EIU Instrument Number (ex. Cl-02)
Does the instrument have a university-owned mouthpiece?

Does the instrument have a university-owned mouthpiece? Yes No
Please list all accessories included (cleaning rod, cleaning cloth, valve or key oil, slide cream, cork grease, etc.)
Does this instrument need REQUIRED repair (as in to make it functional)?

Does this instrument need REQUIRED repair (as in to make it functional)? Yes No
笔濒别补蝉别听fully聽explain the repair needed.聽
Does this instrument need cosmetic or some non-essential repair?

Does this instrument need cosmetic or some non-essential repair? Yes No
笔濒别补蝉别听fully聽explain the repair needed.

You must do this to turn it in!
Have you cleaned out your instrument thoroughly?

Have you cleaned out your instrument thoroughly? Yes No

You must do this to turn it in!
Have you cleaned and vacuumed out your instrument case? (Vacuum located in GA office.)

Have you cleaned and vacuumed out your instrument case? (Vacuum located in GA office.) Yes No

You must do this to turn it in!
Have you cleaned out your EIU instrument locker and wiped it with a wet towel?

Have you cleaned out your EIU instrument locker and wiped it with a wet towel? Yes No

You must do this to turn it in!
Specific date the instrument was last used by you. Specific date the instrument was last used by you. / MM / DD YYYY
Do you need this instrument for graduation?

Do you need this instrument for graduation? Yes No

You must do this to turn it in!
What ensemble is this instrument PRIMARILY used for?
Select a day to turn in your instrument at the Band GA Office (#0354) or Professor Boggs Office (#0357)

Select a day to turn in your instrument at the Band GA Office (#0354) or Professor Boggs Office (#0357) Wednesday, May 6, 2026 - 10:00 am - 2:00 pm Thursday, May 7, 2026 - 10:00 am - 2:00 pm (Wind Symphony ONLY) - Saturday, May 9, 2026 - After the last graduation ceremony.