Barclays Premier League
Boleyn Ground, Upton Park
Saturday 5 December
KO 15:00 GMT

Allocation: 2,900

Tickets:   £45.00- Adults
                  £25.50 - Over-65s
                  £22.50 - Under-16s 

The deadline for applications has now passed.

Ballot results will be made available from Friday 20 November.