Which team do you represent?
Other:
Which team did you play?
Other:
What was the date of the fixture?
What was the nature of the fixture?
League
Cup
Friendly
What was the
score at half-time?
(Your score
first)
What was
the
score
at full-time?
(Your
score first)
What
was the score after extra-time?
(Leave blank if not applicable)
What
was the score after penalties?
(Leave blank if not applicable)
Were
you Home or Away?
Home
Away
Who were your goal scorers?
What was the
referee's name?
How would you
rate the referee's performance?
(A separate
report should be submitted with any rating of 4 or below)
Brief reason
for any referee score of 4 or below
How would you
rate your opponents Sportsmanship?
(A separate
report should be submitted with any rating of 2 or below)
Brief reason
for any fair play score of 2 or below
Were there any yellow
or red cards?
(Please list
players from both sides, use the codes below to give details)
