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About
Strategic Plan 2023-26
Associations
Board
Executive Committee
Standing Committees
Life Membership
Annual Reports & Yearbooks
Careers
Contact
Resources
Circulars & Memos
Declaration of Leagues
Forms
Policies & Documents
Rules & Regulations
Member Protection
Member Protection
Working with Children Check
Safeguarding Children
Help for Kids
Football NSW Child Protection Training Requirements
Training Courses
Anti-Doping
First Aid & Defibrillators
Mental Health & Wellbeing
Managing Poor Behaviour & Bullying
Complaints & Complaint Handling
Workplace Health & Safety
Media
Media Accreditation
Our Game Media Network
Social Media Policy
Sponsors
Football NSW Sponsors
Sponsorship Information & Enquiries
Insurance
Injury Insurance
Injury Claim Form
Top-Up Cover
Certificates of Currency
Sanction Information
Serious Injury Report
Risk Management
Injury Prevention
Tribunal
Regulations
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Determinations
NSW Football Legacy Program
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×
Home
News
Get Involved
Competitions
Match Centre
Competitions Hub
NPL New South Wales
Football NSW Leagues
Futsal
Youth Competitions
Junior Development Leagues
Tournaments
Australia Cup
Bathurst Cup
Champion of Champions
Country Cup
Junior Development Cup
Proctor Park Challenge
Sapphire Cup
State Cup
Waratah Cup
Trial Match Requests
Fixture Alterations
Football NSW Competitions Clubs Directory
Players
Players Hub
Find a Club
Talented Player Programs
Talent Support Program
Future Sapphires Program
State Teams
Female Football Programs
Daughters & Dads
Girls Love Football
Kick-On for Women
Inclusion Football
NOVA Employment football4all
Para Football
Powerchair Football
NOVA Employment AWD Futsal
First Nations Football
Multicultural Football
Host a Football4All Program
Walking Football
Trial Information
Positions Available
Clubs
Clubs Hub
Club Changer
Community Activations
Club Development Conference
Grants and Funding
Positions Available
Coaches
Coaches Hub
Coaching Courses
Coaching Workshops
Club Coach Coordinator Program
Female Coach Education
Coaching Conference
Futsal Coaching Expo
Referees
Referees Hub
Become a Referee
Referee Upgrade Courses
Referee Assessor/Coach Courses
Talented Referee Pathway
Referee Development Panel
Referee Academy
Football NSW Referees Branch
Female Referee Scholarships
Resources
Schools
Schools Hub
MiniRoos Schools Programs
High School Development Program
Futsal Schools Championships
Futsal
Futsal Hub
Competitions
Futsal Match Centre
Futsal Premier League
Futsal Premier League 2
NOVA Employment AWD Futsal
Winter Futsal League
Futsal Schools Championships
Metro State Team Trials
Country State Team Trials
Futsal Coaching Expo
Futsal Coaching Courses
Futsal Referee Courses
Home
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Prescribed Form 09
Prescribed Form 09
"
*
" indicates required fields
Member Details
Full Name
*
First
Last
FFA Cup
*
Club Name
*
Your Email
*
Decision of the Disciplinary Committee
Date of Notice of Suspension
*
DD slash MM slash YYYY
Date of Decision in Respect of Your Challenge
*
DD slash MM slash YYYY
Copy of Notice of Suspension
*
Max. file size: 15 MB.
Copy of decision regarding your challenge
*
Max. file size: 15 MB.
Jurisdiction
Does the Appeals Tribunal have jurisdiction to hear this matter?
Yes
No
The jurisdiction of the Appeals Tribunal is set out in section 10.1 of the Football NSW Grievance and Disciplinary Regulations (Regulations). The Appeals Tribunal will only hear an appeal iif it relates to a decision that was made by the Disciplinary Committee pursuant to section 8.3 of the Regulations (appealing a decision of the DC (Red Card Offences)).
Further, the Participant must satisfy one or more grounds of appeal set out in section 10.2 of the Regulations.
Please state the grounds you wish to rely on
A party was not afforded a reasonable opportunity to present its case
Lack or excess of jurisdiction
The decision of the Body was affected by actual bias
The decision was one that was not reasonably open to the Body having regard to the evidence before the Body
Severity, only where the decision of the Body imposed a sanction of at least:
i) A Fixture Suspension of six (6) or more Fixtures; or
ii) A Time Suspension of three (3) or more months; or
iii) A fine of three thousand dollars ($3000) or more; or
iv) A loss of six (6) or more competition points; or
v) Expulsion from a competition.
Please provide relevant facts and legal arguments that relate to each of the grounds of appeal that you wish to rely on.
*
Affected Party
Please provide relevant facts and legal arguments that relate to each of the grounds of appeal that you wish to rely on.
*
Yes
No
Please describe the relief that you are seeking
*
Notes:
1. Please submit this form within 7 working days of the issuance of the decision of the DC to the Club by Football NSW.
2. Please lodge a fee of $750 together with this Notice. Payment can be made by cheque or direct debit into Football NSW’s bank account. Bank: National Aust Bank Ltd, Account Name: Football NSW Limited, BSB: 082-356, Account Number: 14-055-1058. Please file receipt of payment into this account with the Tribunal Administrator at tribunal@footballnsw.com.au.
3. Participants should read and consider sections 8, 10 and 13 of the Regulations prior to signing and lodging this Notice to Football NSW.
4. If Football NSW does not receive a properly completed Notice by the time specified in paragraph 1 together with the $750 fee, you are deemed to have waived your right to appeal the decision of the DC.
5. Capitalised words used in this document are defined in the Regulations.
Submission
Your name
*
First
Last
Digital Signature
*
I certify that the information entered above is true and correct and was entered myself
Δ