*1.What is your full name?(Required.)

*2.What type of company do you work for?(Required.)

*3.What is your email address? (Required.)

*4.What is your mobile telephone number?(Required.)

5.Is there a specific time of the day you would be happy for us contacting you?

8am - 11am

11am - 2pm

2pm - 5pm

After 6pm

6.Are you a Gillingham Football Club supporter?

Yes

No

*7.What is your preferred method of communication? (Required.)

Email

Telephone

Whatsapp/Text