All fields marked with a * are required entries
STATEMENT OF COST FOR PRIVATE HIRE OF MEDINA THEATRE
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STATEMENT OF COST FOR PRIVATE HIRE OF MEDINA THEATRE
Fairlee Road Newport Isle of Wight PO30 2DX
Tel : 01983-527020 - Fax : 01983-822821
Statement of cost for hire of Medina theatre -
This form must be taken to the theatre box office to be completed along with the Application form for hire of Medina Theatre.
NOTE: Completion of both forms does not confirm booking.
For Office Use Only:
Contract number ...............................................
Organisation
*
Name of organisation
Registered charity no.
(if applicable)
Event details
*
Date of event
----
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
Year
---
Jan
Feb
March
April
May
June
July
Aug
Sep
Oct
Nov
Dec
Month
----
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
*
Hirer
*
Event
Hire charge
Accommodation
Small dressing rooms
1
2
3
4
Large dressing room
Yes
No
Scene dock
Yes
No
Rostra
Yes
No
If chairs are required on stage, please state how many
Fields marked '*' are required entries.
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