Notice of Response to a Charge

Notice of Response to a Charge

Prescribed Form 10
Member Name:
Your Email Address (parent/guardian email address of persons under 18)*
example@example.com
Your Club Name*
Reference Number:*
You are*

18 years of age or older17 years of age or younger
If you selected that you are 17 years of age or younger, please have your parent/guardian present when you submit your Notice.
Plea Entry

Pleading NOT GUILTY, or GUILTY but but dispute the penalties proposed or grading proposed will result in a hearing.
Number of Charges:*
Charge 1:
Charge 2:
Charge 3:
Charge 4:
Charge 5:
Charge 6:
Refief Sought:
Please type the refeif sought that you deem reasonable for all charges
Supporting Documents

Upload any further written submissions that you wish the Disciplinary Committee to consider if you wish to refer to a hearing.
Cancelof
Representation

Select only if you are referring to a Hearing
Do you wish to be accompanied by a member of your Club?

YesNo
Do you wish to be accompanied by a lawyer?

YesNo
Submission
Completed By:

First NameLast Name
The Application Fee has been paid:

YesNo
Digital Signature*

I certify that the information provided is true and accurate
Should be Empty:

Plea Entry