State League Match Reschedule Request Form

State League Match Reschedule Request Form
Club*
Division*
Gender*

MenWomen
Club team
Opposition club*
Opposition team
Contact name*

First NameLast Name
Contact email*
example@example.com
Contact number*
Club position*

Club DelegateClub PresidentOther
Change request type*

DateTimeVenueOther
Current match date*

DayMonthYear
Date
Current match venue & court*
Current match time*

:HourMinutesAM/PM Option
Do either teams have duty associated with the current match?*

YesNo
If yes, please list all match venue & court
If yes, please list the venue, court and time for all applicable matches
Proposed match date*

DayMonthYear
Date
Proposed match venue & court*
Proposed match time*

:HourMinutesAM/PM Option
Proposed match date prior to finals series*

YesNo
Are you able to provide the following for duty at the rescheduled fixture?*

1st referee2nd refereeScorer2 x lines judges
Reason for change request*
DECLARATION

I have read and agree to all match rescheduling requirements as established in By-Law 12 of the State League By-Laws.
Should be Empty: