Arsenal f. C. – Supporters consultative forum application form for groups a-e



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ARSENAL F.C. – SUPPORTERS CONSULTATIVE FORUM

APPLICATION FORM FOR GROUPS A-E

I wish to apply to become a representative of the following group:-






Category

Additional details to complete under “Proof of Category” below

Select ONE category only by placing a cross (X) below


A

Red Member


Membership number




B

Platinum (Club Level) Member


Membership number




C

Executive Box representative


Box number




D

Disabled supporter representative

Membership number





E


Away scheme Member

Membership number





YOU MAY ONLY STAND FOR ONE CATEGORY, AND CAN ONLY RETURN ONE APPLICATION FORM.
Name:
Address:
Post code:
Date of birth: ……………………………………………………………………
Contact telephone number: ……………………………………..………………
Email address……………………………………………………………………
Proof of category (see above) : …………………………………………………

Declaration: I, the above named applicant, confirm that I wish to apply to become a representative on the Supporters Consultative Forum, and that the information provided on this form is accurate.
Signature: Date:

COMPLETED APPLICATIONS MUST ARRIVE WITH ELECTORAL REFORM SERVICES NO LATER THAN 12.00PM ON FRIDAY 21st MAY 2010.

Postal address: Elliot Roberts, Electoral Reform Services, 33 Clarendon Rd, London N8 0NW



Email address: Elliot.Roberts@electoralreform.co.uk

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