Application to run Virgin London Marathon April 2019.

Thank you for applying to join the London Marathon team for 2019 – places will be allocated after the results of the official ballot have been announced and our number of places in the event is finalised.

To be considered please complete this formand return it to:

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

______

NAME:

ADDRESS:

POSTCODE:

EMAIL:MOBILE:

VEST SIZE: XS S M L XL XXL

DOB:

MINIMUM AGE FOR THE LONDONMARATHON IS 18

You will need to enter the run online via the London Marathon website if your application is successful and the terms and conditions of the race entry set out will be applicable to you. ERUK is unable to offer any training advice, and runners should seek medical advice before undertaking an appropriate race training programme.

Please do enter the Official Virgin London Marathon Ballotwhere possible. Our places are very limited and we hope some entrants will be lucky in this way.

I have entered the ballot □Yes □No

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

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

Have you fundraised for Epilepsy Research UK previously?

Why do you want to take part in the London Marathon?(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 an outline of your fundraising plan to let us know how you mightachieve 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?

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 Previous support RunforCharity Google or other search engine other (please specify)

If your application is successful and we allocate you one of our Golden Bond places, you will hear from ERUK with regards the run and your fundraising for the event. Following the London Marathon 2019, we’d love to continue 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 post  text  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