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* 1. First Name

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* 2. Last Name

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* 3. Contact Email

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* 4. Which club do you support

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* 5. Are you a member of your clubs Disabled Supporters Association 

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* 6. Are you a member of a non-disabled supporters organisations e.g Supporters Trust

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* 7. Do you require any reasonable adjustments to attend the Zoom call, e.g. subtitles?

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* 8. We will be taking questions on the night, but if you would like to ask a question in advance, please do so below

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* 9. Are you a free Level Playing Field member

If you would like to know more about becoming a Level Playing Field member, then please click this link

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