NCYSA Notice of Appeal

NCYSA Discipline & Appeals

Notice of Appeal
Date of Appeal Submission:*

MonthDayYear
Date
Email Address:*
example@example.com
Name of Person Filing the Appeal (Appellant):*

First NameLast Name
Association Name:*
Select one:*

This is an INDIVIDUAL filing an appealThis is an ASSOCIATION filing an appeal
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number:*
Please enter a valid phone number.
Secondary Phone Number:
Please enter a valid phone number.
Opposing Party (If applicable):
Date of Decision Being Appealed:*

MonthDayYear
Date
Statement of Appeal

Please type a short summary of your appeal statement below and attach your full and detailed appeal statement to the document submission box below the summary statement.
Appellant Summary of Appeal - On what grounds are you appealing the Appellee's Decision? *
Statement of Appeal & Supporting Documentation Upload*

Cancelof
Witness Information
Appeal Payment Information
I hereby certify that this Notice of Appeal is being electronically filed and payment has been made to the following address:

North Carolina Youth Soccer Association

c/o Discipline and Appeals

PO Box 18229

Greensboro, NC 27419
I understand that a NON-REFUNDABLE appeal fee of $300 must be included with the Notice of Appeal forms and statements submitted to NCYSA.*

I, the Appellant, certify that I understand the above statement and have submit the payment to NCYSA.
Date*

MonthDayYear
Date
Signature of Appellant*

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NCYSA Discipline & Appeals

Statement of Appeal

Appeal Payment Information