NOTICE OF RESPONSE

NOTICE OF RESPONSE (SECTION 8.2)
Prescribed Form 12

MEMBER DETAILS

Full Name

First NameLast Name

FFA or DRIBL Number

Club Name

NOTICE DETAILS

Date of Notice of Charge

DayMonthYear

Reference Number

PLEA ENTRY

Charge 1: Please tick your chosen option

Charge 2: Please tick your chosen option

Charge 3: Please tick your chosen option

Charge 4: Please tick your chosen option

Charge 5: Please tick your chosen option

DOCUMENTS TO SUPPORT YOUR CHOSEN ACTION

Please upload any written submissions that you wish the Disciplinary Tribunal to consider when determining any sanction that may be imposed.

Upload a File

You may upload multiple files. Only PDF, DOC and DOCX files accepted. Max. file size 4MB

REPRESENTATION

If you are under the age of 18, you must be accompanied by your parent/guardian

Do you wish to be represented by a support person of the Club / Association?

Please provide name and contact details of Club / Association representative

Do you wish to be supported by a lawyer?

Please provide name and contact details of the legal representative

Notes:

1. Please submit this form by the date referred to in the Notice of Charge.

2. Unless there is a reasonable excuse, if FC does not receive a properly completed Notice of Response by the time specified in paragraph 1 above, you are deemed to have pleaded guilty to the charge(s) set out in the Notice of Charge and accept the reports attached to the Notice of Charge.

3. Participants should read and consider section 8.2 (Charges of Misconduct and Disrepute) and section 12 (Administrative Procedures of Tribunals) prior submitting this Notice of Response to FC.

4. Capitalised words used in this document are defined in the Regulations.

SUBMISSION

Your name

First NameLast Name

E-mail Address

A copy of your submission will be emailed to this address.

Digital Signature

Submission Date

DayMonthYear