Chime Loan Application

Applications are now being accepted for the 2023/2024 school year. The deadline to submit an application is June 30, 2023.

"*" indicates required fields

Step 1 of 3

Borrower Name*

First Last

Borrower Street Address*

Borrower Address Line 2

Borrower City*

Borrower State*

Borrower Zip*

Borrower Phone*

Borrower Email*

Organization Name

Organization Address

Street Address Address Line 2 City State ZIP Code

Organization Phone

Organization Email

Do you already have a mentor with knowledge of handchimes?*

Mentor Name

First Last

Mentor Phone

Mentor Email

Give a brief summary of the musical and leadership experience of the person who will be implementing the program.

Select the type of facility where the chimes will be used.

Other: describe below

Describe the population who will be using the handchimes (grades, ages, special needs, etc.)

Describe how the handchimes will be incorporated into your music program.

Phone

This field is for validation purposes and should be left unchanged.