2016 AFL Season Launch Fan Media Event Survey

1.Member number (if applicable):

2.Please enter your details below..(Required.)

First Name:

Surname:

Gender:

Street Address:

Suburb:

Post Code:

Email:

Mobile Number:

Clothing Size:

Dietary Requirements:

3.Tell us in 30 words or less why you should be chosen as 1 of 20 fans to represent the Western Bulldogs at this event:

4.Western Bulldogs Privacy Policy.(Required.)

By registering for this competition you acknowledge that you are available to partake in this event at the following time and place:

Victory Room, Etihad Stadium (enter via gate 2)
Arrival time: 7.45am (approximate finish time of 9.45am)
Transport and accommodation will not be provided by the AFL or the Western Bulldogs. Participants are expected to provide their own transport to and from the stadium.

All personal information you provide will be used by the Western Bulldogs Football Club, AFL and on behalf of selected third parties in accordance with our Privacy Policy, this may include for promotional and direct marketing purposes and other disclosures as specified in our Privacy Policy found at westernbulldogs.com.au/Privacy . By providing your personal information, you agree to such use.

2016 AFL Season Launch Fan Media Event

Are you our most dedicated fan? Win you place in the 2016 AFL Season Launch Event