FL Carling Cup Quarter Final Burnley FC vs Arsenal

Turf Moor - Tuesday 2nd December 2008

Home Supporters Postal Application Form

Name

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Address

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Post Code

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Daytime Telephone No.

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Clarets No.

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I wish to apply for:

. . . . . . . . . . . . . Adult tickets @ £20 each

£

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. . . . . . . . . . . . . .Concession tickets @ £15

£

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. . . . . . . . . . . . . .Junior tickets @ £10

£

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Total

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£

In

Bob Lord / JH Upper/ JH Lower / JM Upper / JH Lower Stand

Block:

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Note:

We will do our best to sit you as close to your desired location

as possible, but cannot guarantee this. We will allocate the best

alternative unless you tell us not to do so.

I wish to pay by cheque / credit card (DELETE as applicable)

I hereby instruct you to debit my account:

My credit card details are: VISA/MASTERCARD/MAESTRO/DELTA/SOLO/SWITCH

Number:

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Valid From:

 __ __ / __ __   Expiry Date: __ __ / __ __   Issue No: __ __

Return To:

Ticket Office, Harry Potts Way, Burnley, BB10 4BX

Please enclose:

Stamped addressed envelope and your cheque if applicable

PLEASE DO NOT SEND CASH IN THE POST