FRIENDS OF THE WURLITZER MEMBERSHIP FORM

 

Annual membership for New Zealand residents is NZD $20.00 per postal address.

 

We have two options available –

A) a normal subscription  OR…….

B) a yearly “Season Ticket” which includes membership & seats to all the Wurlitzer Shows.

                   (Only available at the start of each year)

OPTION A:

NORMAL SUBSCRIPTION = NZ $ 20.00

                                                   
Donation                               = NZ $...........................

                                                 
TOTAL Payment                 = NZ $...........................            

 

 

OPTION B:
*Please phone 522-8944 for seat allocation & to check the price of this year’s Season Ticket

 

SEASON TICKET                = NZ $ ...........................

 

Donation                            = NZ $..........................

 

TOTAL Payment               = NZ $..........................

 

PLEASE ADD MY NAME TO THE FRIENDS OF THE WURLITZER MAILING LIST.

 

PAYMENT BY INTERNET BANKING

1. Call or E-mail Jan Denise FIRST,  to confirm the correct amount for e-payment.
   PH: 522-8944   /   EMAIL: jandenise@xtra.co.nz
   
   
2. Our Bank Account details + info we need from you;
   Account Name: The Wurlitzer Organ Trust of Auckland
   Account Number: 12-3045-0449278-00
   Particulars:  Your Name                           Reference: Subs

 

* PLEASE NOTE – WE CAN NO LONGER ACCEPT CHEQUE PAYMENTS

 

If possible scan or email this form to jandenise@xtra.co.nz

MR / MRS / MISS / MS ________________________________________________________________________________________

 

ADDRESS: ________________________________________________________________________________________

 

________________________________________________________________________________________

 

PHONE:  _____________________________   EMAIL:  ____________________________________________

 

 

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Under the Privacy Act, we must advise you that the information you have given above will be treated as confidential and will only be used for events involving the Hollywood Theatre and the Wurlitzer Organ Trust of Auckland.  Your details will not be supplied to any other group your organization without your prior consent.

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