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 Cheque                                 = NZ $
...........................           

 

………………..OR

 

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 Cheque                                 = NZ $..........................

 

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

ENCLOSED IS MY CHEQUE MADE PAYABLE TO THE WURLITZER ORGAN TRUST OF AUCKLAND.

 

MR / MRS / MISS / MS ________________________________________________________________________________________

 

ADDRESS: __________________________________________________________________________________________________

 

________________________________________________________________________________________

 

PHONE:  _____________________________   EMAIL:  ____________________________________________

 

PLEASE PRINT OUT AND MAIL IN THIS FORM, TOGETHER WITH YOUR CHEQUE, TO

 

FOTW MEMBERSHIP SECRETARY – Mrs Jan Nancekivell

C/- 3/23 ROTOMAHANA TCE

REMUERA

AUCKLAND 1050

NEW ZEALAND

 

Please note: We are now able to accept payments by internet banking – please contact Jan Nancekivell for the account details and information required when making e-payment.

 

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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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