Visa Card number: Expiry Date

Gift Sadler’s Wells Friends Form When signed and completed, please return to Ticket Office, Sadler’s Wells, Rosebery Avenue, London EC1R 4TN I would like to purchase a Friends membership as a gift at £55

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Purchaser Name.………………………………………………………………………………………. Address.………………………………………………………………………………………………… ……………………………………………………………………………………………………………. ………………………………………………………………Postcode………………………..………. Telephone…………………………………… Email …………………………………………………

Gift Recipient Name.………………………………………………………………………………….. Address.………………………………………………………………………………………………… ……………………………………………………………………………………………………………. ………………………………………………………………Postcode………………………..………. Telephone…………………………………… Email …………………………………………………

Payment Details I would like to pay by direct debit

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(Please complete direct debit mandate form overleaf)

I would like to pay by cheque

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(Cheques to be made payable to Sadler’s Wells Trust Ltd)

I would like to pay by card

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 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………………………………………………………………………………...

Rehearsal Membership Direct Debit Form Gift Rehearsal Membership to be paid annually  Name.………………………………………………………………………………………………. Address.……………………………………………………………………………………………. ………………………………………………………………………………………………………. ………………………………………………………………Postcode…………………..……….. Telephone…………………………………… Email ……………………………………………… Direct Debit is a simple form of automatic annual renewal and helps us to reduce administration.

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