Date of Match

SUSSEX COUNTY FOOTBALL LEAGUE (Must be returned within three days of match) Date of Match Division / Cup Home Team Visitors Team Goals Goals

HOME SUBSTITUTES (Names & Numbers) 12 Replaced After mins 14 Replaced After mins 15 Replaced After mins 16 Replaced After mins 17 Replaced After mins

AWAY SUBSTITUTES (Names & Numbers) 12 Replaced After mins 14 Replaced After mins 15 Replaced After mins 16 Replaced After mins 17 Replaced After mins

REFEREES ASSISTANTS (Indicate mark) Name: Name: 10 9 8 7 6 5 4 3 2 1 10 9 8 7 6 5 4 3 2 1

CLUB SPORTMANSHIP MARK (Indicate mark) Home Team Away Team 10 9 8 7 6 5 4 3 2 1 10 9 8 7 6 5 4 3 2 1

HOME MISCONDUCT (Cautioned/Sent off) AWAY Player Player Player Player Player Player Player Player

DISCIPLINARY OFFENCES Club failing to provide ground directions etc. Club presenting late / no team sheets Club failing to provide linesman Team playing short complement Team responsible for late start Any other matters to report

DETAILS OF MATCH OFFICIALS (Names of Officials must be completed) Match Officials Name Fee Expenses Referee Assistant 1 Assistant 2

Name / address of sender