Page 26 - The Twelfth Man - Issue 1
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 Membership Form Issue 1 Joining the Liverpool Disabled
Supporters Association (LDSA)
The LDSA represents and supports all disabled supporters and people who enable them to be supporters of Liverpool FC. Our funding is from membership fees, income from LDSA events and donations. It is our intention
to hold an end of season event where we hope to present the winner of our first team player of the year with his award, a Christmas party in one of the lounges at Anfield and a number of other social events throughout the year. The LDSA membership is open to all disabled supporters, their families, carers/personal assistants and costs just £5 per person per annum.
    LDSA Membership Application Form
 Title: Address:
County/Country: Phone Number:
First Name:
Surname:
Town: Postcode:
Yes No Yes No
       Email: Do you consider yourself to have a Disability? (Please tick)
  Do you use a Mobility Aid? (I.e. Wheelchair, Crutch etc.) (Please tick) If yes to either of the questions above please give brief details.
         Do you have a LFC Season Ticket?
Do you have a LFC Membership?
LDSA Membership required:
Preferred method of contact (One option only):
Yes No
Yes No
Family
Email
Please send completed forms with cheque or postal order for £5 to: LDSA 10th Floor, 20 Chapel St, Liverpool, L3 9AG.
Alternatively you can scan and email your completed form to ldsa@liverpoolfc.com – on receipt of your email we will provide you with our bank details to pay via bank transfer.
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Carer/Pa
Disabled
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