Musica Viva Australia

CONFIRM YOUR CITY

Please confirm your city isBrisbane

NEW OR RENEWING SUBSCRIBER

Are you a new or renewing suscriber?

•  New
•  Returning

RENEWING SUBSCRIBER DETAILS

Subscriber number:
Subscription type:	Full  Concession  Under 30  Student
Reserve:	A Res  B Res  C Res
Current seats:
Do you want to change your current seats:	Yes  No
If yes, I would like to be seated:	Aisle  Stalls  Level 1  Balcony

CHOOSE YOUR SUBSCRIPTION

Please Choose Your Subscription

•  Gold
•  DIY Standard
•  DIY Flexi

GOLD Gold subscription entitles the owner to attend each of the performances
TYPE	A RESERVE		B RESERVE		C RESERVE			SUB-TOTAL
Full		x $285.00		x $222.00		x $178.00	$
Concession		x $248.00		x $193.00		x $147.00	$
Under 30						x $120.00	$
Student						x $70.00	$
						TOTAL

DIY Standard
TYPE	A RESERVE		B RESERVE		C RESERVE			SUB-TOTAL
Full		x $195.00		x $153.00		x $123.00	$
Concession		x $171.00		x $135.00		x $96.00	$
Under 30						x $78.00	$
Student						x $45.00	$
						TOTAL

Please indicate below which 3 concerts you wish to attend:

•  Barker, Coleman-Wright & Lane
•  Pekka Kuusisto & Simon Crawford-Phillips
•  Takacs Quartet
•  Eggner Trio
•  Jerusalem Quartet

DIY Flexi
TYPE	A RESERVE		B RESERVE		C RESERVE			SUB-TOTAL
Full		x $195.00		x $153.00		x $123.00	$
Concession		x $171.00		x $135.00		x $96.00	$
Under 30						x $78.00	$
Student						x $45.00	$
						TOTAL

DO YOU REQUIRE ADDITIONAL TICKETS?

•  Yes additional tickets required

ADDITIONAL TICKET LIST

•  Barker, Coleman-Wright & Lane
•  Pekka Kuusisto & Simon-Crawford Phillips
•  Takacs Quartet
•  Eggner Trio
•  Jerusalem Quartet

ADDITIONAL TICKETS

Barker, Coleman-Wright & Lane 21 May	Reserve	Full		Concession		Under 30			Sub-Total
	A Reserve		x $58.00		x $50.00			$
	B Reserve		x $45.00		x $40.00
	C Reserve		x $36.00		x $32.00		x $30.00

Pekka Kuusisto & Steven Osborne 25 June	Reserve	Full		Concession		Under 30			Sub-Total
	A Reserve		x $64.00		x $56.00			$
	B Reserve		x $50.00		x $43.00
	C Reserve		x $40.00		x $34.00		x $30.00

Takacs Quartet 6 August	Reserve	Full		Concession		Under 30			Sub-Total
	A Reserve		x $64.00		x $56.00			$
	B Reserve		x $50.00		x $43.00
	C Reserve		x $40.00		x $34.00		x $30.00

Eggner Trio 24 September	Reserve	Full		Concession		Under 30			Sub-Total
	A Reserve		x $53.00		x $46.00			$
	B Reserve		x $41.00		x $36.00
	C Reserve		x $33.00		x $29.00		x $30.00

Jerusalem Quartet 9 October	Reserve	Full		Concession		Under 30			Sub-Total
	A Reserve		x $58.00		x $50.00			$
	B Reserve		x $45.00		x $40.00
	C Reserve		x $36.00		x $32.00		x $30.00

YOUR DETAILS

Gift:

•  This is a Gift Subscription

Title:MrMrsMissOther First name: Surname: Address: Suburb: State:NSWACTTASQLDNTVICWASAOther Postcode: Telephone (day): Telephone (eve): Telephone (mob): Email address Send me Know the Score e-news:

•  Yes Please send me e-news

Pension Type: Pension No: Name of Institution: I would like to add an accompanying subscriber:

•  Yes add a subscriber

ADDITIONAL SUBSCRIBER DETAILS

Gift:

•  This is a Gift Subscription

Title:MrMrsMissOther First name: Surname: Address: Suburb: State:NSWACTTASQLDNTVICWASAOther Postcode: Telephone (day): Telephone (eve): Telephone (mob): Email address

TAX DEDUCTIBLE DONATION

I want to help Musica Viva to make the extraordinary happen by making a donation of (please select amount):

•  $25
•  $50
•  $100
•  Other

Other $ Please acknowledge me EITHER:

•  as shown in Step 3
•  OR

as follows or

•  I wish to remain anonymous

•  Please send me more information about how I can support Musica Viva's activities through the Virtuosi or Bequest programs.

How did you hear about Musica Viva's 2008 subscription season?

•  Print ad
•  Foxtel ad
•  Musica Viva Mailing
•  Musica Viva website
•  Friend
•  Previous Subscriber
•  Single Ticket Buyer
•  Review/Article

Other

PAYMENT

Card type:VisaAmexMastercardBankcardDiners Club Card No: Month:JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Year:2007200820092010201120122013201420152016 Cardholder's name: Address: Suburb: State:NSWACTTASQLDNTVICWASA Postcode: Amex ID No:

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