Patron Renewal Form I would like to join as a Sadler’s Wells Patron: Opening night Patron
£600 (£567.00 DD)
Commissioning Patron
£1000 (£945.00 DD)
New Production Patron
£2500 (£2362.50 DD)
Season Patron
£5000 (£4752.00 DD)
Name.………………………………………………………………………………….. Address.………………………………………………………………………………. ………………………………………………………………………………………….. …………………………………………………… Postcode………………………… Telephone……………………… Email………………………………………………
Joining as a Patron entitles you to be acknowledged in Sadler’s Wells programmes. Please enter below how you wish to be acknowledged or whether you would prefer to remain anonymous ………………………………………………………………………………………… I would also like to give a donation of £……………………………………………
Payment Details I would like to renew by credit card Visa
MasterCard
Switch
American Express
Card number: Expiry Date
Security Code
Issue No. (Switch Only)
Name of card holder as it appears on the card: ………………………………………………………………………………… Card Holder’s Signature………………………………………………………………………
I would like to renew by cheque
(Cheques to be made payable to Sadler’s Wells Trust Ltd)
I would like to renew by direct debit
Direct Debit is a simple form of automatic annual renewal and helps us to reduce administration, receive a 5.5% discount on the price of your membership when you pay by Direct Debit.
I would like to pay (tick as appropriate): Monthly Quarterly Annually Instruction to your Bank or Building Society to pay Direct Debit (please complete in full) To the manager of__________________________________Bank/Building Society Address ___________________________________________________________ __________________________________________________________________ Postcode___________________________
Originators Identification No 6 5 2 7 9 8 Reference No. (Office use only) Instruction to your Bank or Building Society to pay by Direct Debit – Please pay Sadler’s Wells Trust Ltd. Direct Debits from the account detailed in the instruction subject to safeguards assured by the Direct Debit Guarantee. I understand that this instruction may remain with Sadler’s Wells Trust Ltd and, if so, details will be passed electronically to my Bank/Building Society
Name(s) of Account Holder(s)_______________________________________________ Sort Code_______________Bank/Building Society/Account No_____________________ Signature_______________________________________________________________ Date _____________________________
Banks and Building Societies may not accept Direct Debit instructions for some types of account