| Your Name: | .............................................................................................. |
| Address: | .............................................................................................. |
| Town: | .............................................................................................. |
| Province / District: | .............................................................................................. |
| Country: | .............................................................................................. |
| Post / Zip code: | .............................................................................................. |
| Tel: | .............................................................................................. |
| Type of piano: | Square __ Cabinet __ Upright __ Grand __ |
| Serial number: | .............................................................................................. |
| Number of octaves: | .............................................................................................. |
| Compass: | .............................................................................................. |
| If your piano is a grand: | Overall Width ___ Overall Length ___ |
| Please send this form plus your cheque to: | Broadwood Archive Services 29 Newland Park Drive, York YO10 3HR UK. |
Our bank details:
Account name:John Broadwood & Sons Ltd.
Bank: Yorkshire Bank, Whitby branch, North Yorkshire. YO211BB. UK.
Sort code: 05-09-79.
Account number: 280 006 09.
IBAN number (for overseas enquiries): GB29 YORK 0509 7928 000609.
SWIFT/BIC: YORK GB 21979.
When making any payments directly into our account, please identify your name and also the pianos serial number in the payment details.