Ticket Booking Form
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1Wednesday 12 March 2014
Tobacco Dock, E1W
Ticket Booking Form
Please complete in full using BLOCK CAPITALS. All fields are mandatory and must be completed in full unless specifically
noted otherwise
BOOKING CONTACT:
Name
Company
Address line 1
Address line 2
Town/City
County
Post code
Email
Telephone
TICKET REQUEST:
QUANTITY
NET
VAT
GROSS
SUBTOTAL
Industry (individual)
£360
£72
£432
£
BAFTA member **
£210
£42
£252
£
TOTAL:
£
** Members may purchase up to two tickets at this rate, these tickets are allocated by ballot
PAYMENT:
Indicate preferred method of payment
Card
Invoice
Cheque
Cardholder name / Billing contact
Company
County
Address line 1
Post code
Address line 2
Email
Town/City
Telephone
Credit / Debit Card Details: Complete if paying by card
Card type
Visa
Mastercard
Solo
Maestro
Card number
/
/
/
Security code
Valid from
/
Expiry date
/
Issue number
Cheque Details: Complete if paying by cheque
Invoice Details: Complete if paying by invoice
I enclose a cheque payable to BAFTA for
£
PO number
AUTHORISATION:
By signing below I hereby certify:
1.
That all information provided above is true and correct
2.
That I have read and understood the important information provided at the bottom of this form
That in the event of a successful ticket allocation BAFTA are authorised to request payment in line with the details and
instructions provided above.
Print name
Position
Signature
Date
Forms should be sent to Kelly Smith, BAFTA, 195 Piccadilly, London W1J 9LN and must be returned by Friday 28 February 2014
Return of this form does not guarantee ticket availability. You will be contacted by BAFTA to confirm your booking. For further information
about the event, please contact Kelly Smith on +44 (0) 20 7292 5821 . The ticket price includes reception, dinner, ceremony
and party at the Tobacco Dock. There will be a 100% cancellation charge for any tickets cancelled within 10 working days of the event.
Payment must be received in full before tickets will be released. This form must be completed in full. Attendance to BAFTA events is subject to
eligibility criteria. Tickets are personal to the original purchaser and cannot be resold, assigned, auctioned, donated, transferred, disposed of
or otherwise made available to any third party in any manner whatsoever. BAFTA reserves the right to refuse entry to any person who is not
the original purchaser.
VAT Registration No:
653 3113 65
Office use only:
GA/ TAB / 14 /
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