Access Membership Application Form

MAYFLOWER THEATRE & MAST MAYFLOWER STUDIOS ACCESS MEMBERSHIP

APPLICATION FORM
How to join

To join the Access Membership, please complete this application form. This form must be submitted in the members name alongside proof of eligibility. If any person would like to make bookings on the behalf of the member, this needs to be stated under the, ‘Do you wish to authorize someone to book on your behalf?’ section of the application form. This would authorize them to make bookings and amend existing bookings for the member.

Please note, if the applicant is under 18, there has to be an adult added as 'someone to book on your behalf'.

Each application will be reviewed on a case by case basis.

Please read the Access Membership notes before submitting an application.

If you would like a printed version of this application please email access@mayflower.org.uk

To see more details about access within our building please email access@mayflower.org.uk
Your Details

(Access Member)
Please complete the details below.
Name*

TitleFirst NameLast Name
Address*

Street Address

Street Address Line 2

CityCounty

Postal CodeCountry
Telephone*
E-mail
Date of Birth (if under 18)

DayMonthYear
Do you wish to authorise someone to book on your behalf?

YesNo
Name*

TitleFirst NameLast Name
Address*

Street Address

Street Address Line 2

CityCounty

Postal CodeCountry
Telephone*
E-mail
Do you wish to authorise another person to book on your behalf?

YesNo
Name*

TitleFirst NameLast Name
Address*

Street Address

Street Address Line 2

CityCounty

Postal CodeCountry
Telephone*
E-mail
example@example.com

Proof of Eligibility
Please upload or send in copy of proof of eligibility. Please do not send in any original documents as we are unable to return these to you.
I am submitting the following proof of eligibility:

Middle or Higher rate of Disibility Living AllowanceAttendance AllowancePersonal Independence PaymentBlue Badge (Side with name/image on)Certificate of Visual ImpairmentCredAbility Access CardOther
Please attach proof of eligibility:*

Upload a File

Cancelof
Please note: your application and payment for any reservations cannot be processed until proof of eligibility has been seen.

If sending by post, please mail a copy to Access Membership, Mayflower Theatre, Empire Lane, Southampton, SO15 1AP.

Contact Preferences / Interests
We will contact you by email regarding the Access Membership. If you would also like to receive information about Mayflower Theatre shows and events please select below:

PostEmailPhone
Leave unticked if you do not wish to receive information.

MAYFLOWER THEATRE & MAST MAYFLOWER STUDIOS ACCESS MEMBERSHIP

Your Details

Proof of Eligibility

Contact Preferences / Interests

Access Requirements