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RACE WALKING ASSOCIATION


REQUEST FOR INFORMATION PACK
PLEASE FILL IN THIS FORM TO OBTAIN OUR INTRODUCTORY PACK ON RACE WALKING
Title and Name

Address including Post Code

THE FOLLOWING ITEMS MAY BE OMITTED BUT WILL HELP US IF WE HAVE QUERIES
 Telephone Number
 Fax Number
E-mail Address

THE FOLLOWING ITEMS ARE OPTIONAL BUT WILL HELP US TO KNOW WHO IS USING THE SITE

ABOUT YOU
 Year of birth  Sex: Female - Male- Reply withheld


HAVE YOU DONE ANY OF THE FOLLOWING?
  Running  Race Walking  Speed Walking
 Power Walking

HOW DID YOU LEARN ABOUT THE R.W.A. WEB SITE?
  Search Engine  Link from another Site  Printed Reference
 Personal Reference  Other
If you ticked "Printed Reference" or "Other", it will be helpful if you give details in the box below.

You may have the Introductory Pack sent either by E-mail (approx. 125 megabytes) or by post. Please select the method:  E-mail Post

ANY ADDITIONAL INFORMATION YOU MAY WISH TO GIVE
CONFIDENTIALITY AND CHILD PROTECTION
N.B.: Apart from the optional items above and your post code, which may be employed for statistical purposes, no use will be made of the information given
except for direct communication from the Honorary General Secretary of the R.W.A. No information will be released without your permission to any third party in a form by which you can be individually identified.

IF YOU ARE UNDER SIXTEEN YEARS OF AGE, PLEASE TELL A PARENT OR GUARDIAN THAT YOU ARE SENDING THIS INFORMATION REQUEST FORM.


To clear the Form and start again: To send the Form: To abandon the Form, return to INTERESTED IN WALKING?