United v Shakhtar
Tue 10 Dec, 19:45 GMT
All fields marked with an asterix must be completed.
If your travel details change or any information is incorrect please call 0161 868 8000 immediately to discuss.
All match tickets need to be collected in person from or near to the relevant away city, by the individual registered holders with their valid original passport. More information about collections is available here.
Simply fill in the form on the next page to access all of our official news and exclusive features, such as behind the scenes content, videos, downloads, tickets and much more...
Copyright, Manchester United Ltd, 2013 Photography provided by Manchester United Ltd and Getty Images