unitedwejamneed

What musical instrument or music equipment are you looking to replace? *

Artist or Band Name: *

Your Name: *

Daytime/Cell #: *

Email: *

Electronic Signature: Please type your electronic signature in the box below *

I truthfully pledge that my need for a donation of a musical instrument or music equipment as a result of losing mine in Hurricane Harvey is truthful and sincere. *

Yes

Please tell us about your music career. What did you use the instrument for? *

Address: *

Is your music equipment loss covered by your insurance? *

Yes

City: *

Zip: *

State: *

Any additional message:

If you are a local singer or band in the Houston area who was affected by Hurricane Harvey and have lost music equipment, we feel for you and want to help.

If you would like to apply to receive a donation of a guitar or other music equipment,

just complete the form below and we will try to help.

Note: Only one item per artist or band can be given.