Application to run Virgin London Marathon April 2018.

Thank you for applying to join the London Marathon team for 2018 – places will be allocated after the results of the official ballot have been announced and our number of places is finalised.

To be considered please complete this formand return it to:

Epilepsy Research UK, PO Box 3004, LondonW4 4XT or mail to:

______

PLS COMPLETE IN BLOCK CAPITTALS OR TYPE

NAME:

TITLE:

ADDRESS:

POSTCODE:

EMAIL:MOBILE):

VEST SIZE: S M L XL

DOB:

MINIMUM AGE FOR THE LONDONMARATHON IS 18

Conditions of entry as stated on the official event entry forms apply to all race entries.

Runners should seek medical advice before undertaking an appropriate race training programme.

Have you entered the Official Virgin London Marathon Ballot? □Yes □No

Have you run the London Marathon before?□Yes □No

If Yes, when? For Charity? How much raised?

Why do you want to fundraise for Epilepsy Research UK?(please be as detailed as possible, demand for our places is huge and the more information we have the fairer we can be)

Minimum sponsorship = £1,650. How much do you hope to raise?£

(pls be specific with a genuine estimated amount)

Please provide a fundraising plan to let us know how you plan to achieve this?

Are you able to provide your story for press releases to your local paper?

Occupation/Employer:

Does your company operate a matched giving scheme?

Charity fundraising you have done before:

If applying for more than one place, each applicant must complete this form. Please give the name of the other applicant here and why you wish to run together:

There is no minimum sponsorship target for independent entry, if you are successful in the ballot we’d love you to join our team!

How did you hear about Epilepsy Research UK?

London Marathon website RunforCharity Google or other search engine other (please specify)

Mailing List

We’d love to keep you up to date with the latest news from Epilepsy Research UK about our fundraising, events and research. Please tick the boxes if you would like to hear from us via:

 email, includes our e-newsletter (monthly)

by post, includes our Focus Newsletter (3 issues per year)

 by text

 by telephone

Thank you for your interest in supporting our work, your commitment is important to us. We will let you know whether you have been successful in gaining a place with us as soon as the results of the official ballot have come out either by the email or phone number provided.

Epilepsy Research UKPO Box 3004 London W4 4XT

t 020 8747 5024 f 0870 838 1069 e w

Registered office: Chiswick Town Hall, Heathfield Terrace, London W4 4JN. Registered charity no: 1100394