Join our team for the 2017 Virgin Money London Marathon

The Bobby Moore Fund holds a limited number of Golden Bond places for the 2017 Virgin Money London Marathon and we want you to join our team to help us bring forward the day that bowel cancer is cured. We ask that you raise at least £1966 and you’ll need to pay a £100 deposit for your place if you are successful which will go towards your fundraising target. Please complete this form in block capitals and return to the address overleaf by Friday 19 August 2016. We will notify all applicants in September 2016 as to whether they have been successful in gaining a Golden Bond place. Giving as much detail as possible will give you the very best chance of being successful.

Personal details:

Title: First Name: Surname: Address:

Post code Occupation Name of company: Date of birth: Mobile number: Email:

What is your sponsorship target?

How do you plan to reach your fundraising target?

Please continue of a separate sheet of A4 if necessary

Is your company supporting you? Yes No If yes, please provide details of the support e.g. matched giving scheme

Are you running with a group of friends or colleagues? Yes No Please provide their names below:

PLEASE TURN OVERLEAF TO COMPLETE THE REST OF YOUR APPLICATION Will you be running in fancy dress? Yes No If yes, please provide details:

What is your main experience of cancer?

What has motivated you to run for us?

Please continue of a separate sheet of A4 if necessary

Have you supported The Bobby Moore Fund before? Yes No If yes, please provide details below:

Please tick the statement which applies to you: I have applied to the official ballot I have not applied to the official ballot

Would you be happy to share your story with other runners and / or the media? Yes No One of our press officers may contact you if you agree to share your story

Become part of the movement to bring forward the day when all cancers are cured. Hear about our latest breakthroughs, campaigns and how you can help support our life saving work

Yes please, I’d like to hear from you by email Yes please, I’d like to hear from you by text message or MMS Sorry, I don’t want to hear from you by post or telephone

I have read and agree to Cancer Research UK’s terms and conditions and privacy statement These can be found at www.cruk.org/marathon

Your declaration: I pledge to raise a minimum of £1,966 (excluding Gift Aid) for The Bobby Moore Fund in return for a Golden Bond place in the 2017 Virgin Money London Marathon. I understand that any money raised by my sponsors will be transferred to The Bobby Moore Fund without undue delay.

Signature of Applicant: Date :

Thank you so much for taking the time to fill this form in. Please return by Friday 19 August 2015 to [email protected] or by post to: Sports Team, Cancer Research UK, Angel Building, 407 St John Street, EC1V 4AD If you have any questions about your application please phone 020 3469 8912 Calls cost 8p per minute plus network extras.

Cancer Research UK Registered Charity No. 1089464 and SC041666 and 1103