Full Name



Date of Birth



Have you ever been a member of another supporters club?

lf so, which branch and when?

Have you ever been convicted for football violence offences?

lf yes, please give details...

Are you a season ticket holder?

Leeds United Customer Number

I hereby confirm that the information provided is correct.

*Please only press "Send" once, a short delay should be expected once the button has been pressed.

Current membership fees are as follows
Adults (1 8 years and over).....£7
Juniors (under 18).....free
Senior citizens (65 years and over).....free