2016-17 NCRRS Disciplinary Report
Referees, Please use this form to document disciplinary incidents that involve the violation of law 10.4 (http://laws.worldrugby.org/?law=10.4). Once submitted an email will be sent to the disciplinary chair(s) of the competition and will include a document that contains the information you provided. Each citation should be a unique report. DO NOT USE THE SAME REPORT FOR MULTIPLE CITATIONS.
Referee's Name
First and last name
Your answer
Match date
MM
/
DD
/
YYYY
Referee's email
Please use your pelicanrefs.com google account
Your answer
Player's club
Your answer
Player's name
last name, first
Your answer
Match location
Your answer
Competition
Please use the "other" field to document contact person for a match where the citation meting will be conducted outside of any Northern California competition
Required
Discipline chair contact
Ensure that the email listed above matches the email noted in the discipline chair contact(s), in some cases you may need to check more than one email address. This will ensure the correct person receives the notification. If the violating player is from a different union use the "other" field to note the correct email address.
Required
Player CIPP
CIPP number. Use the following link to research the name and find the cipp #: http://usarugby.org/rosters
Your answer
Referee's action
Law cited
Use the law number, if you know it. Otherwise put it into words. A link to the IRB law book is here: http://laws.worldrugby.org/index.php?language=EN
Your answer
Other details
What other relevant details can you provide? Example: "At approximately 12 minutes into first half John doe, WEARING RED 6 punched Jane doe WEARING GREEN 12, resulting in a red card"
Your answer
More information forthcoming
We should talk ASAP (referee, check "yes" and provide phone number if needed in the "other field").
Required
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