Birmingham Hippodrome Patrons Brochure

Instruction to your Bank or Building Society to pay

by Direct Debit

Birmingham Hippodrome Patrons Birmingham Hippodrome Hurst Street Birmingham B5 4TB

ORIGINATOR’S IDENTIFICATION NUMBER:

8 | 3 | 0 | 9 | 0 | 8 REFERENCE (to be completed by Birmingham Hippodrome):

NAME(S) OF ACCOUNT HOLDER(S):

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|

|

|

|

BANK/BUILDING SOCIETY ACCOUNT NUMBER:

|

|

|

|

|

|

|

|

|

|

|

|

|

Instruction to your Bank or Building Society Please pay Birmingham Hippodrome Direct Debits from the account detailed in this instruction subject to the safeguards assured by the Direct debit Guarantee. I understand that this Instruction may remain with Birmingham Hippodrome and, if so, details will be passed electronically to my Bank/Building Society.

BRANCH SORT CODE:

|

|

|

Name and full postal address of your Bank or Building Society TO: THE MANAGER BANK/BUILDING SOCIETY:

WHAT THOSE INVOLVED SAY...

In addition to the great benefits the Patrons’ scheme is a fantastic way to support the theatre you love and the vital work undertaken within education and access. Your support will enable us to create new and unforgettable theatrical experiences for thousands of people of all ages, abilities and walks of life.

BIRMINGHAM YOUNG CARERS SUMMER PROJECT “On behalf of the parents of all the young carers, I’d like to say how much this means to us and our children...this has given my daughter the most wonderful

Thank You

T AY AR PL P UR YO

Please fill in the whole form using a ball point pen and send it to:

As a registered charity receiving no public subsidy, Birmingham Hippodrome relies on income from ticket sales, ancillary income, donations and in-kind support

Birmingham Hippodrome Theatre Development Trust Registered Charity No. 511567 Chair – Mark Smith Trustees – Fiona Alexander, Simon Boardman-Weston, John Crabtree, Andrew Connors, John Driver, Nicola Fleet-Milne, Martin Guest, Jane Herritty, Martin King, Michael Kuo, Jeremy Millington, Ruth Pipkin

opportunity to do something she loves, I’m so proud of her, thank you”

Further ways you can support Birmingham Hippodrome: Leave a Legacy

~

Make a Donation

~

Name a Seat

Parent of Participant

ADDRESS:

CURTAIN RAISER WITH BIRMINGHAM ORMISTON ACADEMY

SIGNATURE(S):

“This was an amazing opportunity POSTCODE:

DATE:

for all involved. Matthew Bourne is incredible and working alongside

(To be completed by Birmingham Hippodrome)

BOOKING REF:

EXPIRY DATE:

members of his company taught PROCESSED BY:

DATE PROCESSED:

the students so much” Gaynor Cheshire, principal at

Please read this guarantee information before signing. A copy of this will be sent to you for your records.

Birmingham Ormiston Academy

The Direct Debit Guarantee • This guarantee is offered by all Banks and Building Societies that take part in the Direct Debit Scheme.

The efficiency and security of the Scheme is monitored and protected by your own Bank or Building Society.

• If the amounts to be paid or the payment dates change, Birmingham Hippodrome Theatre will notify you ten working days in advance of your account being debited or as otherwise agreed.

• If an error is made by Birmingham Hippodrome Theatre or your Bank or Building Society, you are guaranteed a full and immediate refund from your branch of the amount paid.

• You can cancel a Direct Debit at any time by writing to your Bank or Building Society. Please also send a copy of your letter to us.

0844 338 5040* development@birminghamhippodrome.com www.birminghamhippodrome.com/patrons *telephone calls from 5p per minute

Supporting the UK’s most successful theatre

BECOME A PATRON PLEASE COMPLETE THIS FORM AND RETURN IT TO THE ADDRESS OVERLEAF YOUR DETAILS TITLE:

FORENAME/INITIALS:

SURNAME:

ADDRESS:

POSTCODE:

TELEPHONE (DAY/EVE):

EMAIL:

MEMBERSHIP DETAILS I wish to join Birmingham Hippodrome Patrons’ scheme (PLEASE TICK PREFERRED LEVEL)

~ ~ ~ ~

Advance show information Priority booking Personalised booking service

Credit in programmes, website and front of house

~

Special ticket offers with no transaction or exchange fee

~ ~

~

~

The knowledge that your support

Use of Partners’ Lounge on show nights up to four times a year

Invitations to exclusive Patrons’ events

~

All benefits of Supporting Cast Patron plus:

All benefits of Supporting Cast Patron plus:

Ticket credit of £75 per year

~

Invitations to Gala Dinners and

Access to sold out shows up to a Guest Evenings

is contributing to Birmingham

Three complimentary programme

Hippodrome’s Education and

Two complimentary uses of a private hospitality suite during an

(for up to 4 people)

~ ~

Supporting Cast £200

Leading Role £600

Headline Act £1,200

NAME OF JOINT MEMBER (IF APPLICABLE):

evening performance

~ ~

week before Discounted dining

~

Ticket credit of £150 per year

~

Invitations to Gala Dinners and

Access to sold out shows up to a

with my membership (PLEASE COMPLETE A GIFT AID MANDATE BELOW)

I wish to decline all benefits and make my total contribution a donation (PLEASE COMPLETE A GIFT AID MANDATE BELOW)

Guest Evenings week before

~

Please include an additional donation of £

Unlimited use of Partners’ Lounge

PAYMENT DETAILS Either

I wish to pay £

by ANNUAL Direct Debit (PLEASE COMPLETE FORM OVERLEAF)

or

I wish to pay £

in TEN INSTALMENTS by Direct Debit (PLEASE COMPLETE FORM OVERLEAF)

or

I enclose

by CHEQUE made payable to Birmingham Hippodrome

or

I wish to pay £

on show nights (for up to 4 people) vouchers

Access programme

£

by CREDIT/DEBIT CARD (PLEASE COMPLETE THE SECTION BELOW)

NAME ON CARD:

CARD NUMBER:

.... .... .... .... / .... .... .... .... / .... .... .... .... / .... .... .... ....

TYPE OF CARD:

START DATE:

EXPIRY DATE:

MAESTRO / MASTERCARD / VISA / AMERICAN EXPRESS CVV CODE:

SIGNATURE:

GIFT AID DECLARATION Your membership may qualify for Gift Aid, please sign below if you are eligible.

Last year 42 assisted performances took place and over 180 visually impaired people attended a behind the scenes touch tour

Over 25% of tickets are discounted through education, audience development or access initiatives

5,000 people benefit from taking part in workshops, sharing sessions and talks and tours every year

I would like Birmingham Hippodrome (Registered Charity number 511567) to treat all donations I have made since 6 April 2008 and all donations I make hereafter as Gift Aid donations, unless I notify you otherwise. I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year that is at least equal to the amount of tax that all charities I donate to will reclaim. I understand that other taxes such as VAT and Council Tax do not qualify. I confirm I will notify Birmingham Hippodrome if I wish to cancel this declaration, if my name or address changes or if I no longer pay sufficient tax as described above.

SIGNATURE:

BECOME A PATRON PLEASE COMPLETE THIS FORM AND RETURN IT TO THE ADDRESS OVERLEAF YOUR DETAILS TITLE:

FORENAME/INITIALS:

SURNAME:

ADDRESS:

POSTCODE:

TELEPHONE (DAY/EVE):

EMAIL:

MEMBERSHIP DETAILS I wish to join Birmingham Hippodrome Patrons’ scheme (PLEASE TICK PREFERRED LEVEL)

~ ~ ~ ~

Advance show information Priority booking Personalised booking service

Credit in programmes, website and front of house

~

Special ticket offers with no transaction or exchange fee

~ ~

~

~

The knowledge that your support

Use of Partners’ Lounge on show nights up to four times a year

Invitations to exclusive Patrons’ events

~

All benefits of Supporting Cast Patron plus:

All benefits of Supporting Cast Patron plus:

Ticket credit of £75 per year

~

Invitations to Gala Dinners and

Access to sold out shows up to a Guest Evenings

is contributing to Birmingham

Three complimentary programme

Hippodrome’s Education and

Two complimentary uses of a private hospitality suite during an

(for up to 4 people)

~ ~

Supporting Cast £200

Leading Role £600

Headline Act £1,200

NAME OF JOINT MEMBER (IF APPLICABLE):

evening performance

~ ~

week before Discounted dining

~

Ticket credit of £150 per year

~

Invitations to Gala Dinners and

Access to sold out shows up to a

with my membership (PLEASE COMPLETE A GIFT AID MANDATE BELOW)

I wish to decline all benefits and make my total contribution a donation (PLEASE COMPLETE A GIFT AID MANDATE BELOW)

Guest Evenings week before

~

Please include an additional donation of £

Unlimited use of Partners’ Lounge

PAYMENT DETAILS Either

I wish to pay £

by ANNUAL Direct Debit (PLEASE COMPLETE FORM OVERLEAF)

or

I wish to pay £

in TEN INSTALMENTS by Direct Debit (PLEASE COMPLETE FORM OVERLEAF)

or

I enclose

by CHEQUE made payable to Birmingham Hippodrome

or

I wish to pay £

on show nights (for up to 4 people) vouchers

Access programme

£

by CREDIT/DEBIT CARD (PLEASE COMPLETE THE SECTION BELOW)

NAME ON CARD:

CARD NUMBER:

.... .... .... .... / .... .... .... .... / .... .... .... .... / .... .... .... ....

TYPE OF CARD:

START DATE:

EXPIRY DATE:

MAESTRO / MASTERCARD / VISA / AMERICAN EXPRESS CVV CODE:

SIGNATURE:

GIFT AID DECLARATION Your membership may qualify for Gift Aid, please sign below if you are eligible.

Last year 42 assisted performances took place and over 180 visually impaired people attended a behind the scenes touch tour

Over 25% of tickets are discounted through education, audience development or access initiatives

5,000 people benefit from taking part in workshops, sharing sessions and talks and tours every year

I would like Birmingham Hippodrome (Registered Charity number 511567) to treat all donations I have made since 6 April 2008 and all donations I make hereafter as Gift Aid donations, unless I notify you otherwise. I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year that is at least equal to the amount of tax that all charities I donate to will reclaim. I understand that other taxes such as VAT and Council Tax do not qualify. I confirm I will notify Birmingham Hippodrome if I wish to cancel this declaration, if my name or address changes or if I no longer pay sufficient tax as described above.

SIGNATURE:

BECOME A PATRON PLEASE COMPLETE THIS FORM AND RETURN IT TO THE ADDRESS OVERLEAF YOUR DETAILS TITLE:

FORENAME/INITIALS:

SURNAME:

ADDRESS:

POSTCODE:

TELEPHONE (DAY/EVE):

EMAIL:

MEMBERSHIP DETAILS I wish to join Birmingham Hippodrome Patrons’ scheme (PLEASE TICK PREFERRED LEVEL)

~ ~ ~ ~

Advance show information Priority booking Personalised booking service

Credit in programmes, website and front of house

~

Special ticket offers with no transaction or exchange fee

~ ~

~

~

The knowledge that your support

Use of Partners’ Lounge on show nights up to four times a year

Invitations to exclusive Patrons’ events

~

All benefits of Supporting Cast Patron plus:

All benefits of Supporting Cast Patron plus:

Ticket credit of £75 per year

~

Invitations to Gala Dinners and

Access to sold out shows up to a Guest Evenings

is contributing to Birmingham

Three complimentary programme

Hippodrome’s Education and

Two complimentary uses of a private hospitality suite during an

(for up to 4 people)

~ ~

Supporting Cast £200

Leading Role £600

Headline Act £1,200

NAME OF JOINT MEMBER (IF APPLICABLE):

evening performance

~ ~

week before Discounted dining

~

Ticket credit of £150 per year

~

Invitations to Gala Dinners and

Access to sold out shows up to a

with my membership (PLEASE COMPLETE A GIFT AID MANDATE BELOW)

I wish to decline all benefits and make my total contribution a donation (PLEASE COMPLETE A GIFT AID MANDATE BELOW)

Guest Evenings week before

~

Please include an additional donation of £

Unlimited use of Partners’ Lounge

PAYMENT DETAILS Either

I wish to pay £

by ANNUAL Direct Debit (PLEASE COMPLETE FORM OVERLEAF)

or

I wish to pay £

in TEN INSTALMENTS by Direct Debit (PLEASE COMPLETE FORM OVERLEAF)

or

I enclose

by CHEQUE made payable to Birmingham Hippodrome

or

I wish to pay £

on show nights (for up to 4 people) vouchers

Access programme

£

by CREDIT/DEBIT CARD (PLEASE COMPLETE THE SECTION BELOW)

NAME ON CARD:

CARD NUMBER:

.... .... .... .... / .... .... .... .... / .... .... .... .... / .... .... .... ....

TYPE OF CARD:

START DATE:

EXPIRY DATE:

MAESTRO / MASTERCARD / VISA / AMERICAN EXPRESS CVV CODE:

SIGNATURE:

GIFT AID DECLARATION Your membership may qualify for Gift Aid, please sign below if you are eligible.

Last year 42 assisted performances took place and over 180 visually impaired people attended a behind the scenes touch tour

Over 25% of tickets are discounted through education, audience development or access initiatives

5,000 people benefit from taking part in workshops, sharing sessions and talks and tours every year

I would like Birmingham Hippodrome (Registered Charity number 511567) to treat all donations I have made since 6 April 2008 and all donations I make hereafter as Gift Aid donations, unless I notify you otherwise. I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year that is at least equal to the amount of tax that all charities I donate to will reclaim. I understand that other taxes such as VAT and Council Tax do not qualify. I confirm I will notify Birmingham Hippodrome if I wish to cancel this declaration, if my name or address changes or if I no longer pay sufficient tax as described above.

SIGNATURE:

BECOME A PATRON PLEASE COMPLETE THIS FORM AND RETURN IT TO THE ADDRESS OVERLEAF YOUR DETAILS TITLE:

FORENAME/INITIALS:

SURNAME:

ADDRESS:

POSTCODE:

TELEPHONE (DAY/EVE):

EMAIL:

MEMBERSHIP DETAILS I wish to join Birmingham Hippodrome Patrons’ scheme (PLEASE TICK PREFERRED LEVEL)

~ ~ ~ ~

Advance show information Priority booking Personalised booking service

Credit in programmes, website and front of house

~

Special ticket offers with no transaction or exchange fee

~ ~

~

~

The knowledge that your support

Use of Partners’ Lounge on show nights up to four times a year

Invitations to exclusive Patrons’ events

~

All benefits of Supporting Cast Patron plus:

All benefits of Supporting Cast Patron plus:

Ticket credit of £75 per year

~

Invitations to Gala Dinners and

Access to sold out shows up to a Guest Evenings

is contributing to Birmingham

Three complimentary programme

Hippodrome’s Education and

Two complimentary uses of a private hospitality suite during an

(for up to 4 people)

~ ~

Supporting Cast £200

Leading Role £600

Headline Act £1,200

NAME OF JOINT MEMBER (IF APPLICABLE):

evening performance

~ ~

week before Discounted dining

~

Ticket credit of £150 per year

~

Invitations to Gala Dinners and

Access to sold out shows up to a

with my membership (PLEASE COMPLETE A GIFT AID MANDATE BELOW)

I wish to decline all benefits and make my total contribution a donation (PLEASE COMPLETE A GIFT AID MANDATE BELOW)

Guest Evenings week before

~

Please include an additional donation of £

Unlimited use of Partners’ Lounge

PAYMENT DETAILS Either

I wish to pay £

by ANNUAL Direct Debit (PLEASE COMPLETE FORM OVERLEAF)

or

I wish to pay £

in TEN INSTALMENTS by Direct Debit (PLEASE COMPLETE FORM OVERLEAF)

or

I enclose

by CHEQUE made payable to Birmingham Hippodrome

or

I wish to pay £

on show nights (for up to 4 people) vouchers

Access programme

£

by CREDIT/DEBIT CARD (PLEASE COMPLETE THE SECTION BELOW)

NAME ON CARD:

CARD NUMBER:

.... .... .... .... / .... .... .... .... / .... .... .... .... / .... .... .... ....

TYPE OF CARD:

START DATE:

EXPIRY DATE:

MAESTRO / MASTERCARD / VISA / AMERICAN EXPRESS CVV CODE:

SIGNATURE:

GIFT AID DECLARATION Your membership may qualify for Gift Aid, please sign below if you are eligible.

Last year 42 assisted performances took place and over 180 visually impaired people attended a behind the scenes touch tour

Over 25% of tickets are discounted through education, audience development or access initiatives

5,000 people benefit from taking part in workshops, sharing sessions and talks and tours every year

I would like Birmingham Hippodrome (Registered Charity number 511567) to treat all donations I have made since 6 April 2008 and all donations I make hereafter as Gift Aid donations, unless I notify you otherwise. I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year that is at least equal to the amount of tax that all charities I donate to will reclaim. I understand that other taxes such as VAT and Council Tax do not qualify. I confirm I will notify Birmingham Hippodrome if I wish to cancel this declaration, if my name or address changes or if I no longer pay sufficient tax as described above.

SIGNATURE:

Instruction to your Bank or Building Society to pay

by Direct Debit

Birmingham Hippodrome Patrons Birmingham Hippodrome Hurst Street Birmingham B5 4TB

ORIGINATOR’S IDENTIFICATION NUMBER:

8 | 3 | 0 | 9 | 0 | 8 REFERENCE (to be completed by Birmingham Hippodrome):

NAME(S) OF ACCOUNT HOLDER(S):

|

|

|

|

|

BANK/BUILDING SOCIETY ACCOUNT NUMBER:

|

|

|

|

|

|

|

|

|

|

|

|

|

Instruction to your Bank or Building Society Please pay Birmingham Hippodrome Direct Debits from the account detailed in this instruction subject to the safeguards assured by the Direct debit Guarantee. I understand that this Instruction may remain with Birmingham Hippodrome and, if so, details will be passed electronically to my Bank/Building Society.

BRANCH SORT CODE:

|

|

|

Name and full postal address of your Bank or Building Society TO: THE MANAGER BANK/BUILDING SOCIETY:

WHAT THOSE INVOLVED SAY...

In addition to the great benefits the Patrons’ scheme is a fantastic way to support the theatre you love and the vital work undertaken within education and access. Your support will enable us to create new and unforgettable theatrical experiences for thousands of people of all ages, abilities and walks of life.

BIRMINGHAM YOUNG CARERS SUMMER PROJECT “On behalf of the parents of all the young carers, I’d like to say how much this means to us and our children...this has given my daughter the most wonderful

Thank You

T AY AR PL P UR YO

Please fill in the whole form using a ball point pen and send it to:

As a registered charity receiving no public subsidy, Birmingham Hippodrome relies on income from ticket sales, ancillary income, donations and in-kind support

Birmingham Hippodrome Theatre Development Trust Registered Charity No. 511567 Chair – Mark Smith Trustees – Fiona Alexander, Simon Boardman-Weston, John Crabtree, Andrew Connors, John Driver, Nicola Fleet-Milne, Martin Guest, Jane Herritty, Martin King, Michael Kuo, Jeremy Millington, Ruth Pipkin

opportunity to do something she loves, I’m so proud of her, thank you”

Further ways you can support Birmingham Hippodrome: Leave a Legacy

~

Make a Donation

~

Name a Seat

Parent of Participant

ADDRESS:

CURTAIN RAISER WITH BIRMINGHAM ORMISTON ACADEMY

SIGNATURE(S):

“This was an amazing opportunity POSTCODE:

DATE:

for all involved. Matthew Bourne is incredible and working alongside

(To be completed by Birmingham Hippodrome)

BOOKING REF:

EXPIRY DATE:

members of his company taught PROCESSED BY:

DATE PROCESSED:

the students so much” Gaynor Cheshire, principal at

Please read this guarantee information before signing. A copy of this will be sent to you for your records.

Birmingham Ormiston Academy

The Direct Debit Guarantee • This guarantee is offered by all Banks and Building Societies that take part in the Direct Debit Scheme.

The efficiency and security of the Scheme is monitored and protected by your own Bank or Building Society.

• If the amounts to be paid or the payment dates change, Birmingham Hippodrome Theatre will notify you ten working days in advance of your account being debited or as otherwise agreed.

• If an error is made by Birmingham Hippodrome Theatre or your Bank or Building Society, you are guaranteed a full and immediate refund from your branch of the amount paid.

• You can cancel a Direct Debit at any time by writing to your Bank or Building Society. Please also send a copy of your letter to us.

0844 338 5040* development@birminghamhippodrome.com www.birminghamhippodrome.com/patrons *telephone calls from 5p per minute

Supporting the UK’s most successful theatre

Instruction to your Bank or Building Society to pay

by Direct Debit

Birmingham Hippodrome Patrons Birmingham Hippodrome Hurst Street Birmingham B5 4TB

ORIGINATOR’S IDENTIFICATION NUMBER:

8 | 3 | 0 | 9 | 0 | 8 REFERENCE (to be completed by Birmingham Hippodrome):

NAME(S) OF ACCOUNT HOLDER(S):

|

|

|

|

|

BANK/BUILDING SOCIETY ACCOUNT NUMBER:

|

|

|

|

|

|

|

|

|

|

|

|

|

Instruction to your Bank or Building Society Please pay Birmingham Hippodrome Direct Debits from the account detailed in this instruction subject to the safeguards assured by the Direct debit Guarantee. I understand that this Instruction may remain with Birmingham Hippodrome and, if so, details will be passed electronically to my Bank/Building Society.

BRANCH SORT CODE:

|

|

|

Name and full postal address of your Bank or Building Society TO: THE MANAGER BANK/BUILDING SOCIETY:

WHAT THOSE INVOLVED SAY...

In addition to the great benefits the Patrons’ scheme is a fantastic way to support the theatre you love and the vital work undertaken within education and access. Your support will enable us to create new and unforgettable theatrical experiences for thousands of people of all ages, abilities and walks of life.

BIRMINGHAM YOUNG CARERS SUMMER PROJECT “On behalf of the parents of all the young carers, I’d like to say how much this means to us and our children...this has given my daughter the most wonderful

Thank You

T AY AR PL P UR YO

Please fill in the whole form using a ball point pen and send it to:

As a registered charity receiving no public subsidy, Birmingham Hippodrome relies on income from ticket sales, ancillary income, donations and in-kind support

Birmingham Hippodrome Theatre Development Trust Registered Charity No. 511567 Chair – Mark Smith Trustees – Fiona Alexander, Simon Boardman-Weston, John Crabtree, Andrew Connors, John Driver, Nicola Fleet-Milne, Martin Guest, Jane Herritty, Martin King, Michael Kuo, Jeremy Millington, Ruth Pipkin

opportunity to do something she loves, I’m so proud of her, thank you”

Further ways you can support Birmingham Hippodrome: Leave a Legacy

~

Make a Donation

~

Name a Seat

Parent of Participant

ADDRESS:

CURTAIN RAISER WITH BIRMINGHAM ORMISTON ACADEMY

SIGNATURE(S):

“This was an amazing opportunity POSTCODE:

DATE:

for all involved. Matthew Bourne is incredible and working alongside

(To be completed by Birmingham Hippodrome)

BOOKING REF:

EXPIRY DATE:

members of his company taught PROCESSED BY:

DATE PROCESSED:

the students so much” Gaynor Cheshire, principal at

Please read this guarantee information before signing. A copy of this will be sent to you for your records.

Birmingham Ormiston Academy

The Direct Debit Guarantee • This guarantee is offered by all Banks and Building Societies that take part in the Direct Debit Scheme.

The efficiency and security of the Scheme is monitored and protected by your own Bank or Building Society.

• If the amounts to be paid or the payment dates change, Birmingham Hippodrome Theatre will notify you ten working days in advance of your account being debited or as otherwise agreed.

• If an error is made by Birmingham Hippodrome Theatre or your Bank or Building Society, you are guaranteed a full and immediate refund from your branch of the amount paid.

• You can cancel a Direct Debit at any time by writing to your Bank or Building Society. Please also send a copy of your letter to us.

0844 338 5040* development@birminghamhippodrome.com www.birminghamhippodrome.com/patrons *telephone calls from 5p per minute

Supporting the UK’s most successful theatre

Instruction to your Bank or Building Society to pay

by Direct Debit

Birmingham Hippodrome Patrons Birmingham Hippodrome Hurst Street Birmingham B5 4TB

ORIGINATOR’S IDENTIFICATION NUMBER:

8 | 3 | 0 | 9 | 0 | 8 REFERENCE (to be completed by Birmingham Hippodrome):

NAME(S) OF ACCOUNT HOLDER(S):

|

|

|

|

|

BANK/BUILDING SOCIETY ACCOUNT NUMBER:

|

|

|

|

|

|

|

|

|

|

|

|

|

Instruction to your Bank or Building Society Please pay Birmingham Hippodrome Direct Debits from the account detailed in this instruction subject to the safeguards assured by the Direct debit Guarantee. I understand that this Instruction may remain with Birmingham Hippodrome and, if so, details will be passed electronically to my Bank/Building Society.

BRANCH SORT CODE:

|

|

|

Name and full postal address of your Bank or Building Society TO: THE MANAGER BANK/BUILDING SOCIETY:

WHAT THOSE INVOLVED SAY...

In addition to the great benefits the Patrons’ scheme is a fantastic way to support the theatre you love and the vital work undertaken within education and access. Your support will enable us to create new and unforgettable theatrical experiences for thousands of people of all ages, abilities and walks of life.

BIRMINGHAM YOUNG CARERS SUMMER PROJECT “On behalf of the parents of all the young carers, I’d like to say how much this means to us and our children...this has given my daughter the most wonderful

Thank You

T AY AR PL P UR YO

Please fill in the whole form using a ball point pen and send it to:

As a registered charity receiving no public subsidy, Birmingham Hippodrome relies on income from ticket sales, ancillary income, donations and in-kind support

Birmingham Hippodrome Theatre Development Trust Registered Charity No. 511567 Chair – Mark Smith Trustees – Fiona Alexander, Simon Boardman-Weston, John Crabtree, Andrew Connors, John Driver, Nicola Fleet-Milne, Martin Guest, Jane Herritty, Martin King, Michael Kuo, Jeremy Millington, Ruth Pipkin

opportunity to do something she loves, I’m so proud of her, thank you”

Further ways you can support Birmingham Hippodrome: Leave a Legacy

~

Make a Donation

~

Name a Seat

Parent of Participant

ADDRESS:

CURTAIN RAISER WITH BIRMINGHAM ORMISTON ACADEMY

SIGNATURE(S):

“This was an amazing opportunity POSTCODE:

DATE:

for all involved. Matthew Bourne is incredible and working alongside

(To be completed by Birmingham Hippodrome)

BOOKING REF:

EXPIRY DATE:

members of his company taught PROCESSED BY:

DATE PROCESSED:

the students so much” Gaynor Cheshire, principal at

Please read this guarantee information before signing. A copy of this will be sent to you for your records.

Birmingham Ormiston Academy

The Direct Debit Guarantee • This guarantee is offered by all Banks and Building Societies that take part in the Direct Debit Scheme.

The efficiency and security of the Scheme is monitored and protected by your own Bank or Building Society.

• If the amounts to be paid or the payment dates change, Birmingham Hippodrome Theatre will notify you ten working days in advance of your account being debited or as otherwise agreed.

• If an error is made by Birmingham Hippodrome Theatre or your Bank or Building Society, you are guaranteed a full and immediate refund from your branch of the amount paid.

• You can cancel a Direct Debit at any time by writing to your Bank or Building Society. Please also send a copy of your letter to us.

0844 338 5040* development@birminghamhippodrome.com www.birminghamhippodrome.com/patrons *telephone calls from 5p per minute

Supporting the UK’s most successful theatre