<<

BRENTFORD FC HALF SEASON TICKET APPLICATION FORM 2017/18

If you have any queries please call the Ticket Office on 0208 847 2511 (select option 1).

Save time and buy online today at www.brentfordfc.com/seasontickets

Section 1 Personal Details (PLEASE PRINT IN CAPITALS AND FILL OUT ALL BOXES)

Mr Mrs Miss Ms Other Fan number (If known)

Forename Surname

Address

Postcode Date of Birth (mandatory)

Home Telephone Daytime Telephone

Mobile Telephone (please provide for fixture change updates, etc)

Email (please provide for fixture change updates, etc)

Gender: Male Female Update your personal preferences online at brentfordfc.com/tickets

Section 2 New Half Season Ticket Holders

Type of Half Season Ticket: Adult Junior (u18)* Senior (65+)* Young Person (18-24)*

Please complete the boxes below, selecting three areas of the stadium in which you would like to sit. When choosing where in the block to sit (front, middle or back) please number your preferences from 1-3. 1 being your first option and 3 your third option.

Availability near the halfway line is very limited. Applicants are recommended to list a good range of block choices or check and buy online.

Example 1: Stand NEW ROAD Block N500 Front 2 Middle 1 Back 3

I would like to request my Half Season Ticket in the following areas:

Option 1: Stand Block Front Middle Back

Option 2: Stand Block Front Middle Back

Option 3: Stand Block Front Middle Back

* To qualify for a Young Person’s Half Season Ticket you must be under the age of 25 as of August 1st 2017. Juniors are under 18 as of 1st August 2017 and Seniors must be 65 and over as of 1st August 2017. Please include a photocopy of your driving license / passport with your application.

PLEASE SEND YOUR COMPLETED FORM TO: Brentford FC Ticket Office, Braemar Road, Brentford, , TW8 0NT Section 3 Donate to the Brentford Football Club Community Sports Trust The Brentford Football Club Community Sports Trust improves the lives for thousands of local young people through the power of sport. You can help by supporting our variety of programmes that tackle unemployment, disability, health and social inclusion.

I would like to make a donation of £ to the Brentford Football Club Community Sports Trust.

I authorise my donation to be charged to the card detailed in section 6 of my application.

I enclose a separate cheque for my donation made payable to the Brentford Football Club Community Sports Trust. Registered charity number 1112784.

I am a UK taxpayer and I want the Brentford Football Club Community Sports Trust to treat all donations I’ve made for the six years prior to this year (but no earlier than 06/04/2000) and all donations I make from the date of this declaration, as Gift Aid donations, until I notify you otherwise.

Signature Date

Notes: You can cancel this declaration at any time by notifying the charity. You must pay an amount of income tax and/or capital gains tax at least equal to the tax that the charity reclaims on your donations in the appropriate year (28p per £1). Refer to help sheet IR65 on the HMRC website for more details (www.hmrc.gov.uk). Please notify the charity if you change your name or address.

Section 4 Bees United Memberships Bees United is the Supporters Trust that exists to secure the long term future of Brentford FC. Established in 2001 to save the Club, today it has supporters on the Board and a ‘golden share’ protecting our stadium. Help us ensure future generations can support Brentford FC.

I would like to become a 2017/18 BU Member for only £5. Current Membership Number (if known)

I would like to make a donation of £ to Bees United.

Section 5 Half Season Ticket, Trust Donation and/or BU Membership payment details

I enclose a cheque for £ made payable to Brentford Football Club. I would like to pay by instalments and have enclosed my application form. I authorise Brentford Football Club to debit the card detailed below for £ (Plus £1.50 booking fee for Credit Card payments. Debit Card payments incur no booking fees)

Card Number Security Code (last 3 digits on the MasterCard Visa Visa Debit Expiry Date back of your card)

Signature Date

By signing I agree to the Club’s ground regulations and ticketing terms and conditions. See www.brentfordfc.com for full terms and conditions.

Section 6 Disability Brentford Football Club recognises the Disability Discrimination Act (DDA) 2005. For full details on the Club’s disability provisions please visit www.brentfordfc.com/disability

PLEASE SEND YOUR COMPLETED FORM TO: Brentford FC Ticket Office, Braemar Road, Brentford, London, TW8 0NT

Brentford Football Club Limited. Registered in No: 3642327. VAT Reg No: 720524569 Registered Office: , Braemar Road, Brentford, London, TW8 0NT. 2017/18 INSTALMENT PLAN

Spread the cost of your Season Ticket over 4 months

See reverse for details INSTALMENT PLAN APPLICATION

Total Season Ticket(s) Price £ Number of Tickets

Supporter Stand/ Row/ Number 1 Block Seat

Supporter Stand/ Row/ Number 2 Block Seat

Supporter Stand/ Row/ Number 3 Block Seat

4 Month Instalment Plan

YOUR PERSONAL DETAILS

Date of Title MR MRS MISS MS OTHER // Birth Forenames(s)

Surname

Address

Post Code

Home number

Mobile number

Email address

ZEBRA HELPLINE: 01332 680 400 Reference Number (Zebra Finance use only) USE OF YOUR INFORMATION You have the right to know how we will use your personal information. Whether or not your application is accepted, you agree:

In considering your application for credit, we will search your record at credit reference agencies. They will add to your record details of our search and your application and this will be seen by other organisations that make searches.

We will use a credit scoring or other automated decision making systems when assessing your application. If your application is approved, and you enter into an agreement with us, we will use the same system to manage your account, when considering future applications or in extending further credit to you. We will also add to the Credit Reference Agencies’ record details of your agreement with us, the payments you make under it, and any default or failure to keep to its terms.

We will check your details with fraud prevention agencies, and if you give us false or inaccurate information and we suspect fraud, we will record this. Your record will be shared with other organisations and used by them to help make decisions about credit for you and members of your household and also trace debtors, recover debt, prevent money laundering and fraud, and manage your account.

We, the Credit Reference Agencies and Fraud Prevention Agencies will also use your record for statistical analysis about credit and about insurance and fraud. Fraud Prevention Agency records will also be shared with other organisations to help make decisions on motor, household, credit, life and other insurance proposals and insurance claims, for you and members of your household. Zebra Finance may disclose information contained in this agreement to its agents and nominated retailers who relate to this agreement.

Please contact us on 01332 680 400 or by email to the Compliance Manager at [email protected] if you want details of the personal information we hold about you (a fee may be payable) or the details of those Credit Reference and Fraud Prevention Agencies from whom we obtain and share information. CUSTOMER’S DECLARATION a) The particulars given by me in my application (and those of any other parties) are true and correct. b) The agreement will be between me and Zebra Finance which is acting as a credit intermediary for the credit provider R. Raphael & Sons Plc. The Football Club has no involvement in decisions on granted credit. c) I authorise Zebra Finance to apply for any references required to consider my application.

By submitting this application I am consenting to receive unsolicited marketing from you (or other companies you may pass my details to) by letter, telephone or email about products you think may be of interest to me. I can opt-out from receiving marketing from you at any time by contacting you on 01332 680 400 or by email to the Compliance Manager at [email protected]. If I do not wish to receive marketing communications then I will tick the box below.

I do not consent to receiving marketing communications. STATUS DISCLOSURE Brentford FC Limited will introduce you to Zebra Finance who are a broker that introduces prospective borrowers to lenders. If your application is accepted, and you proceed with the credit, then the lender will be R Raphael & Sons Plc. Brentford FC Limited is an Appointed Representative of Zebra Finance Ltd who are authorised and regulated by the Financial Conduct Authority with firm reference number 688465. Their contact details are Lincoln House, Stephensons Way, Wyvern Business Park, Derby DE21 6LY www.zebrafinance.co.uk Brentford FC Limited and Zebra Finance do not receive payment for introducing you to lenders. Credit is subject to application and acceptance. Terms and Conditions will apply which will be notified to you upon your making an application.

Signature Date / /

PLEASE RETURN WITH YOUR SEASON TICKET APPLICATION TO: BRENTFORD FOOTBALL CLUB, BRAEMAR ROAD, BRENTFORD, LONDON TW8 0NT Instalment Plan 4 Month Plan

Instalment Plan Example REPRESENTATIVE EXAMPLE - Amount Of Credit £201.00. Total Amount Repayable £213.00. Repayable by 1st monthly instalment of £62.25 (including admin fee of £12.00) followed by 3 monthly instalments of £50.25. Interest rate 0% pa fixed. Representative 33.6% APR fixed.

Example based upon an Adult 25-64, Road, Standing Terrace, 12 Game Half Season Ticket costing £201.00

Other Terms and Conditions apply. Acceptance subject to credit status.

Brentford FC Limited will introduce you to Zebra Finance who are a broker that introduces prospective borrowers to lenders. If your application is accepted, and you proceed with the credit, then the lender will be R Raphael & Sons Plc. Brentford FC Limited is an Appointed Representative of Zebra Finance Ltd who are authorised and regulated by the Financial Conduct Authority with firm reference number 688465. Their contact details are Lincoln House, Stephensons Way, Wyvern Business Park, Derby DE21 6LY www.zebrafinance.co.uk Brentford FC Limited and Zebra Finance do not receive payment for introducing you to lenders. Credit is subject to application and acceptance. Terms and Conditions will apply which will be notified to you upon your making an application.