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Booking Tickets
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Seating Plan
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Open Venue Hire sub menu
Back
Shows & Film Screenings
Meetings and Conference Hire
Community Hire
Parties, Weddings & Celebrations of Life
Corporate Hospitality
Spaces for Hire – Plans & Specifications
About Us
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Back
The Team
History
Working Here
Archives
Pantomime Archive
Robert Hopkins - Pantomime Producer
Sustainability
Safeguarding
Rushmoor Talent Quest
Contact Us
Essential Companion Scheme Individual Application Form
Essential Companion Scheme Individual Application Form
Details of the person with the disability
First Name
Last Name
Email
Telephone Number
House / Flat Number
Street
Town
Post Code
Will the person with the disability, listed above, be booking the tickets?
*
Yes
No
Type of application
Type of application
*
I am in receipt of the higher rate of the Disability Living Allowance - Care or Mobility Component, the higher rate of Attendance Allowance, the enhanced rate of the Personal Independence Payment - Daily Living or Mobility Component, holds a Certificate of Visual Impairment or holds a Nimbus Access Card with a +1 symbol and would like to apply for a complimentary seat for my Essential Companion.
I am in receipt of the middle rate of the Disability Living Allowance - Care Component, the standard rate of the Personal Independence Payment - Daily Living Component or the lower rate of Attendance Allowance and would like to apply for a 50% ticket price reduction on an adult ticket for my Essential Companion.
Evidence of entitlement
*
Please include a scanned copy of the letter from the Department of Work and Pensions confirming DLA / Attendance Allowance status, Certificate of Visual Impairment or your Nimbus Access Card. You may cross out any monetary amounts.
Details of Representative
Representative First Name
Representative Last Name
Representative email address
Representative Telephone Number
Preferred Contact
Please indicate your preferred contact:
Person with disability (named in section 1)
Personal representative (named on this page)
Additional Information
Which of the following preferences would you like us to record to assist in future bookings:
Aisle Seat
Wheelchair space
Large wheelchair space
Stalls seat
Terrace Seat
Hearing Loop
Other
