MTC Club Membership Fast-track your subscription and enjoy exclusive benefits with an MTC Club membership Double (two people in the same household) @ $400 Individual @ $250
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1. SUBSCRIBER DETAILS
Donations Help your MTC continue to transform lives and make the finest theatre imaginable. See page 32 of the Season brochure for more information on becoming an MTC Donor. $5,000 $2,500 $1,000 $500 $100 $Other
Before completing this form, please consider using our easy online booking service at mtc.com.au/subscriptions Please note, Subscribers wishing to sit together must submit booking forms together.
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Your Details:
2016 Subscriber Member Donor ($1,000+) New Subscriber Account No.
Street
Suburb Postcode
Phone (H)
Vouchers Gift Vouchers: Purchase an MTC Gift Voucher of any value for family and friends ^.
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Programme Vouchers: programmes are now available in foyers for a gold coin donation, therefore it is no longer necessary to pre-order programme vouchers with your subscription.
Previous address
SUBSCRIBER NO. 1: Title Name Email Package Size:
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11
9
8
7 Price type:
Full
GRAND TOTAL
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Visa
Credit card in full
Credit card instalments^
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Cheque enclosed Mastercard
Expiry
Credit card in full
TOTAL
$
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7 Price type:
Full
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11
9
TOTAL
Mastercard
Credit card in full
$
8
7 Price type:
Full
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TOTAL
University of Melbourne Employee# Pensioner Card No#.
2016 Subscriber Member Donor ($1,000+) New Subscriber Account No.
Amex (include $15 handling fee if paying by instalments)
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Under 30
SUBSCRIBER NO. 2: Title Name Package Size:
Credit card instalments^
8
7 Price type:
Full
Under 30 #
Seniors Card No#.
University of Melbourne Employee# Pensioner Card No#.
If you are booking for more than two households, please attach their details by photocopying this form or downloading an additional form from mtc.com.au/subscriptions
Signature |
D.O.B (optional) #
Seniors Card No#.
Full-time Student#
Surname
Mobile No.
Street
Package Size:
University of Melbourne Employee# Pensioner Card No#.
Email
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Under 30#
Seniors Card No#.
Email
Amex (include $15 handling fee if paying by instalments)
Cheque enclosed
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8
SUBSCRIBER NO. 1: Title Name
Credit card instalments^
Name on card
Expiry
Payee 3
Card No.
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Signature |
Card No.
9
Phone (H)
Name on card
Visa
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Household 2:
Payee 2
11
Full-time Student#
Signature
Expiry
Visa
Package Size:
Amex (include $15 handling fee if paying by instalments)
Name on card |
D.O.B (optional)
Mobile No.
Email
Mastercard
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Surname
SUBSCRIBER NO. 3: Title Name
Cheque enclosed
Card No.
Package Size:
University of Melbourne Employee# Pensioner Card No#.
SUBSCRIBER NO. 2: Title Name
Full-time Student#
5. PAYMENT Payee 1
Under 30#
Seniors Card No#.
Email Please consider rounding up your total as a valued donation to MTC. Donations over $2 are tax deductible.
D.O.B (optional)
Mobile No.
Full-time Student# STEP 4 TOTAL
Surname
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SEATING PREFERENCE:
ACCESS NEEDS:
I have included Pensioner/Senior card numbers or copies of ID indicating age under 30 years, full-time student enrolment status or University of Melbourne proof of employment as appropriate.
Playhouse: Stalls Circle
Hard of Hearing
Wheelchair Transfer
Limited Steps
Captioning
Low Vision
Audio Description
Wheelchair Space
Please detail any access related seating requests:
^ Included in your total charge will be a $15 handling fee per credit card used. The first instalment, including any Gift Voucher amounts, is payable when you subscribe with the remaining instalments due on 6 January, 6 April and 6 June 2017. See pages 50 and 51 of the Season brochure for more information.
Auslan - Please let us know if you are interested in this service so that we can contact you once 2017 dates are finalised.
RETURN VIA BY MAIL
OR TO THE SOUTHBANK THEATRE DROP BOX
OR BOOK ONLINE
MTC Subscriptions PO Box 918 South Melbourne VIC 3205