Please print this page, complete the form and fax or mail it to one of  addresses below.

I would like to be advised of all future events held by and agree that my name go on your confidential database

(Please print)

Mrs/Mr/Ms

Surname...........................................................

Christian Name.................................................

Address.............................................................

Ph Bus...............................................................

Ph Res...............................................................

Fax....................................................................

E-mail.................................................................

Signature...........................................................

Under the Privacy Act, this information is for the purpose of building a list to inform list member of up-and-coming events and other ACPAS marketing and information material.  This information will not be given to other companies for their marketing or informational purposes.

Donations

If you wish to make a donation kindly complete this section and return it together with your cheque /credit card authority to

AOTEA CENTRE PERFORMING ARTS SOCIETY

PO Box 5749
Wellesley Street
Auckland

Please accept my donation of $ ..................

 Visa         MasterCard          American Express    (Circle One)

Card No:....................................................................exp date:...............

I enclose a cheque payable to ACPAS or Please debit my Card.