Please return your completed form to Development Department, Hampstead Theatre, Eton Avenue, Swiss Cottage, London, NW3 3EU

YOUR DETAILS Title Full Name Address Postcode Telephone BE A Email I wish to receive emails about productions from Hampstead Theatre I wish to receive emails about fundraising from Hampstead Theatre FRIEND DIRECT DEBIT MANDATE I wish to pay my membership fee of £60 annually on the first of (month). Name(s) of account holder Sort Code Account Number Name and full postal address of your bank/building society Bank/building society Address Postcode Signed Date

Reference (to be completed by Hampstead Theatre) Service User Number

4 3 3 5 3 6

GIFT AID DECLARATION (please tick if you are eligible) I would like Hampstead Theatre to treat all donations that I make from the date of this declaration until I notify you otherwise as Gift Aid donations

Signed Date

Notes on I am a UK taxpayer and understand that if I pay less Income Tax and /or Capital Gains Tax in the current tax year than the amount of Gift Aid claimed on all my donations it is my responsibility to pay any difference. Please notify Hampstead Theatre if you: 1. Want to cancel this declaration 2. Change your name or home address 3. No longer pay sufficient tax on your income and/or capital gains

If you pay Income Tax at the higher or additional rate and want to receive the additional tax relief due to you, you must include all your Gift Aid donations on your Self-Assessment tax return or ask HM Revenue and Customs to adjust your tax code.

This guarantee should be detached and retained by the payer The Direct Debit Guarantee • This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits. • If there are any changes to the amount, date or frequency of your Direct Debit Hampstead Theatre Ltd will notify you (normally 10 working days) in advance of your account being debited or as otherwise agreed. If you request Hampstead Theatre Ltd to collect a payment, confirmation of the amount and date will be given to you at the time of the request. • If an error is made in the payment of your Direct Debit, by Hampstead Theatre Ltd or your bank or building society, you are entitled to a full and immediate refund of the amount paid from your bank or building society. - If you receive a refund you are not entitled to, you must pay it back when Hampstead Theatre Ltd asks you to. • You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us.

Hampstead Theatre is a registered charity, number 218506. Hampstead Theatre is one of the UK’s leading theatres, FOR JUST £60 A YEAR FRIENDS RECEIVE renowned for original, entertaining and ambitious work. ■ Advance Priority Booking Sell-out hits, West End transfers and Olivier Award- ■ Invitations to special events winning triumphs originate here. ■ 10% discount at the Café Bar Our Friends get ahead of the game through Priority ■ Annual Subscription to our supporters Booking for all productions on both stages and access e-newsletter Hampstead Backstage to newly released seats for sold-out shows. All in return and insights into our work for a small and highly appreciated donation which ■ Complimentary ticket exchange directly supports Hampstead Theatre. within productions

BECOME A HAMPSTEAD THEATRE FRIEND TODAY AND NEVER MISS A SHOW AGAIN

Adrian Lester in Martyna Majok’s Cost of Living 2019, winner of the 2018 Pulitzer Prize for Drama