21-Day Rule Request Form

COMPLETE THE ON-LINE 21-DAY NOTICE REQUEST SERVICE BELOW

I will confirm receipt by return of e-mail

Please note: Any submitted results without a valid e-mail address will be rejected as junk mail!

I have also added an IP address tracer and will report abuse of this form to your corresponding IP service provider!

PLEASE NOTE: THIS FORM IS FOR U16'S ONLY

Name:
Name of Club/Team:
21-Day request date:
What type fixture: League Fixture
Cup Fixture
Don't Know
Your Opponents (Leave blank if not known?)
Please indicate how many 21-day rules you have previously applied for:
Date applied:
Email Address: