Mazda London Triathlon 2009 information request form

Title

First name *

Surname *

Address 1 *

Address 2

Town *

County

Postcode *

Email *

Phone *

Are you entering a team or as an individual? -- please select -- Team Individual

Do you already have a place in this event? -- please select -- Yes No

Where did you hear about this event? * -- please select -- Stroke Association Website London Triathlon Website Transition Magazine National Press Search Engine Email Other

If Other, please specify

The Stroke Association would like to keep you informed about the work we are helping to make possible. Please choose 'Yes' if you are happy for us to contact you. -- please select -- Yes No

We will sometimes allow other organisations whose aims are in sympathy with our own to contact our supporters. Please choose 'Yes' if you are happy for these organisations to contact you. -- please select -- Yes No

Are you happy for us to send you information about The Stroke Association's work by email? -- please select -- Yes No

Volunteers play a crucial role in the work of The Stroke Association and in delivering the National Events calendar. Please select 'Yes' if you are happy for us to contact you about volunteering opportunities. * -- please select -- Yes No