National Theater‧Concert Hall

Dear Friends membership application form

Date:dd/mm/yyyy

Name / Birthday / dd/mm/yyyy
Passport No.
( will be your account number) / Gender / □Male □Female
Telephone / office（ ） / Home（ ） -
FAX：（ ） -
Mobile / E-Mail / @
Address / □□□
The Levels of Choice / □Elegance CardNT$ 200
□Elegance Card NT$ 400(Includes free brochure of monthly program )
□Heirloom CardNT$1500
□Treasure CardNT$ 3000
Preferred Payment Method / □ Cash (only for counter service)
□ Visa □ Master □ JCB
Credit Card Number ______-______-______-______
□AMERICAN EXPRESS
Credit Card Number ______-______-______CCV:______
Expiry date: mm/yy
Would you like to receive our e-newsletters / □Yes □ No / Would you like to join the Friends of NSO for free? / □Yes □ No
How do you get the information about the membership of NTCH / □Monthly Brochure of NTCH □DM □Ticket purchase
□Internet □Newspaper□ Magazines □Recommendation of Friends other
※Privacy policy
The details which you provide about yourself and any information which identifies you such as your name, address, email address, telephone number, country of residence and credit card details ("Personal Information") will only be retained by us
We will use your personal information to keep you informed about events, news and offers that we think will be of interest to you. If you have chosen to receive them, we will also use your information to provide you e-newsletters and other e-mail alerts letting you stay up-to-date about relevant offers.
We may also use the information to process any transactions you undertake with us and for internal administration and analysis. We disclose your information to third parties only for providing the above services to you. We do not sell, rent or trade your personal information to third parties for marketing purposes without your consent.
We will provide the information If we are required by law or requested by the police or a regulatory or government authority.
※I declare that, as far as I know, the information I have given is true. I authorize the National Theater and Concert Hall to make any enquiries necessary to verify the information given。
※We reserve the right to withdraw our approval of your application
Signature of the applicant：______

▓How to apply：

A: Apply in person atNational Theater or Concert Hall service counters

B: Fax: (02）3393-9720

C.Email: .