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2023 Post Match Submission Form
The SWVFA 2023 Post Match Submission Form requests any Misconduct Incident Reports, Competition Incident Reports or Facility Reports. Please ensure only one (1) completed Post Match Submission Form is submitted per match.
34
Questions
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1
Name
*
This field is required.
First Name
Last Name
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2
Email
*
This field is required.
example@example.com
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3
Role
*
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Referee
Assistant Referee
Club Official
Referee
Assistant Referee
Club Official
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4
Competition Fixture Date
*
This field is required.
/
Date
Day
Month
Year
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12
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Hour
00
05
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25
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55
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05
10
15
20
25
30
35
40
45
50
55
Minutes
AM
PM
PM
AM
PM
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5
Please select which Competition the incident occurred?
*
This field is required.
Men's Division 1
Men's Division 2
Women's Division
Under 17s
Under 14s
Under 12s
Cup Competitions/Friendly Match
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6
Home Team/Club
*
This field is required.
Corangamite Lions FC
Hamilton Raiders SC
Portland Panthers SC
Port Fairy SC
Stawell Pioneers SC
Warrnambool Rangers SC
Warrnambool Wolves SC
Corangamite Lions FC
Hamilton Raiders SC
Portland Panthers SC
Port Fairy SC
Stawell Pioneers SC
Warrnambool Rangers SC
Warrnambool Wolves SC
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7
Away Team/Club
*
This field is required.
Corangamite Lions FC
Hamilton Raiders SC
Portland Panthers SC
Port Fairy SC
Stawell Pioneers SC
Warrnambool Rangers SC
Warrnambool Wolves SC
Corangamite Lions FC
Hamilton Raiders SC
Portland Panthers SC
Port Fairy SC
Stawell Pioneers SC
Warrnambool Rangers SC
Warrnambool Wolves SC
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8
Please upload the relevant Match Record/s
*
This field is required.
Includes Team Sheets, etc
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
Browse Files
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9
Was a Red Card issued during this fixture?
*
This field is required.
YES
NO
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10
How many Red Cards were issued in this fixture?
1
2
3
Contact FV if more than 4
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11
Offending Player Details
*
This field is required.
First Name
Last Name
FFA ID
Shirt Number
Corangamite Lions FC
Hamilton Raiders SC
Portland Panthers SC
Port Fairy SC
Stawell Pioneers SC
Warrnambool Rangers SC
Warrnambool Wolves SC
Corangamite Lions FC
Hamilton Raiders SC
Portland Panthers SC
Port Fairy SC
Stawell Pioneers SC
Warrnambool Rangers SC
Warrnambool Wolves SC
Please Select Club
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12
Please select the applicable offense
*
This field is required.
R1 - Denying the opposing team a goal or an obvious goal-scoring opportunity by a handball offense
R2 - Denying a goal or an obvious goal-scoring opportunity to an opponent whose overall movement is towards the offender's goal by an offense punishable by a free kick
R3 - Serious foul play
R4 - Biting or spitting at someone
R5 - Violent conduct
R6 - Using offensive, insulting or abusive language and/or gestures
R7 - Receiving a second caution in the same match
R8 - Offenses against a Match Official
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13
Incident Details
*
This field is required.
How many metres away from the ball did the incident occur?
What minute did the incident occur?
How many metres away from the incident was the referee?
If anyone was injured, please specify
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14
Please provide a detailed explanation of the incident.
*
This field is required.
Please be as specific and detailed as possible and use wording from the LOTG. Quote and use exact language/force used where applicable.
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15
Second Offending Player Details
*
This field is required.
First Name
Last Name
FFA ID
Shirt Number
Corangamite Lions FC
Hamilton Raiders SC
Portland Panthers SC
Port Fairy SC
Stawell Pioneers SC
Warrnambool Rangers SC
Warrnambool Wolves SC
Corangamite Lions FC
Hamilton Raiders SC
Portland Panthers SC
Port Fairy SC
Stawell Pioneers SC
Warrnambool Rangers SC
Warrnambool Wolves SC
Please Select Club
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16
Please select the applicable offense - Second Incident
*
This field is required.
R1 - Denying the opposing team a goal or an obvious goal-scoring opportunity by a handball offense
R2 - Denying a goal or an obvious goal-scoring opportunity to an opponent whose overall movement is towards the offender's goal by an offense punishable by a free kick
R3 - Serious foul play
R4 - Biting or spitting at someone
R5 - Violent conduct
R6 - Using offensive, insulting or abusive language and/or gestures
R7 - Receiving a second caution in the same match
R8 - Offense against a Match Official
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17
Incident Details - Second Incident
*
This field is required.
How many metres away from the ball did the incident occur?
What minute did the incident occur?
How many metres was the referee from the incident?
If anyone was injured, please specify
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18
Please provide a detailed explanation of the incident - Second Incident
*
This field is required.
Please be as specific and detailed as possible and use wording from the LOTG. Quote and use exact language/force used where applicable.
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19
Third Offending Player Details
*
This field is required.
First Name
Last Name
FFA ID
Shirt Number
Corangamite Lions FC
Hamilton Raiders SC
Portland Panthers SC
Port Fairy SC
Stawell Pioneers SC
Warrnambool Rangers SC
Warrnambool Wolves SC
Corangamite Lions FC
Hamilton Raiders SC
Portland Panthers SC
Port Fairy SC
Stawell Pioneers SC
Warrnambool Rangers SC
Warrnambool Wolves SC
Please Select Club
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20
Please select the applicable offense - Third Incident
*
This field is required.
R1 - Denying the opposing team a goal or an obvious goal-scoring opportunity by a handball offense
R2 - Denying a goal or an obvious goal-scoring opportunity to an opponent whose overall movement is towards the offender's goal by an offense punishable by a free kick
R3 - Serious foul play
R4 - Biting or spitting at someone
R5 - Violent conduct
R6 - Using offensive, insulting or abusive language and/or gestures
R7 - Receiving a second caution in the same match
R8 - Offense against a Match Official
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21
Incident Details - Third Incident
*
This field is required.
How many metres away from the ball did the incident occur?
What minute did the incident occur?
How many metres was the referee from the incident?
If anyone was injured, please specify
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22
Please provide a detailed explanation of the incident - Third Incident
*
This field is required.
Please be as specific and detailed as possible and use wording from the LOTG. Quote and use exact language/force used where applicable.
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23
Were there any additional Misconduct incidents you wish to report that were not addressed in any of the previous questions?
*
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ie. Misconduct that was not isolated to an individual or falls outside of the fields as listed above and that is outside the LAWS OF THE GAME. Note that any competition specific incidents such as strip clashes or game abandonment's are not to be included in the following section and will be requested later in the Form.
YES
NO
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24
Please provided a detailed explanation of the Misconduct incident.
*
This field is required.
Please ensure quotes and exact words are used as best as possible and include any witnesses of the incident where necessary. e.g. throwing of objects onto the playing field or abuse towards the match official after the game
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25
Were there any Competition specific incidents you wish to report
*
This field is required.
ie. Incidents that fall outside of the relevant RULES OF COMPETITION or LAWS OF THE GAME. Note that any competition specific incidents such as strip clashes or game abandonment's should be included in this section.
YES
NO
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26
Do you wish to complete the mandatory Competition Incident Report now online or complete the paper form at a later date?
*
This field is required.
Please note Competitions Incident Reports are compulsory to complete if an incident has occurred. If you do not wish to complete this now, please download the template from RefereesHQ and send any completed report/s to lachlan.cole@footballvictoria.com.au
Yes, I would like to complete the form now online
No, I would like to complete the paper form at a later date
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27
Please detail the Competition specific incident - quote and use exact words where necessary
*
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e.g. Players from the away team were wearing a strip that clashed with home team.
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28
Do you wish to provide a report regarding the facility and pitch conditions?
*
This field is required.
A report is required if there are significant concerns to the facility and pitch conditions. If you wish to complete the paper form at a later date, select NO and download the template from RefereesHQ and send any completed report/s to lachlan.cole@footballvictoria.com.au
YES
NO
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29
Please provide the Venue Name
*
This field is required.
Please select from the drop down below
Pedrina Park - Hamilton
Scotts Creek Reserve - Corangamite
Jones Oval - Warrnambool Rangers
Harris Street Reserve - Warrnambool Wolves
North Park - Stawell
JJ Colledge Reserve - Port Fairy
Friendly Societies Reserve - Portland
Pedrina Park - Hamilton
Scotts Creek Reserve - Corangamite
Jones Oval - Warrnambool Rangers
Harris Street Reserve - Warrnambool Wolves
North Park - Stawell
JJ Colledge Reserve - Port Fairy
Friendly Societies Reserve - Portland
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30
Do the following conform to the Laws of the Game?
Yes
No
Yes
No
Yes
No
Yes
No
Goal Posts (dimensions, colour, location, condition, nets)
Corner Flags (height, non pointed top, flag present)
Line Markings (dimensions, visibility, width)
Technical Area (defined, pitch proximity)
Goal Posts (dimensions, colour, location, condition, nets)
Corner Flags (height, non pointed top, flag present)
Line Markings (dimensions, visibility, width)
Technical Area (defined, pitch proximity)
Yes
No
Yes
No
Yes
No
Yes
No
1
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31
Do the following items conform to facility and pitch standards?
Yes
No
Yes
No
Yes
No
Yes
No
Stretcher (present and suitable)
Crowd Control (police, security, or marshals present)
Referee Security (marshals escort on and off pitch)
Pitch boundary lines at least three metres from fence or other hazard?
Stretcher (present and suitable)
Crowd Control (police, security, or marshals present)
Referee Security (marshals escort on and off pitch)
Pitch boundary lines at least three metres from fence or other hazard?
Yes
No
Yes
No
Yes
No
Yes
No
1
of 4
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32
Ground Surface Conditions
Please drag the slider to make a selection
Ground Evenness
Grass Cover
Grass Length
Ground Traction
Ground Hardness
Not Satisfied
Somewhat Satisfied
Satisfied
Very Satisfied
Not Satisfied
Somewhat Satisfied
Satisfied
Very Satisfied
Not Satisfied
Somewhat Satisfied
Satisfied
Very Satisfied
Not Satisfied
Somewhat Satisfied
Satisfied
Very Satisfied
Not Satisfied
Somewhat Satisfied
Satisfied
Very Satisfied
Ground Evenness
Grass Cover
Grass Length
Ground Traction
Ground Hardness
Not Satisfied
Somewhat Satisfied
Satisfied
Very Satisfied
Not Satisfied
Somewhat Satisfied
Satisfied
Very Satisfied
Not Satisfied
Somewhat Satisfied
Satisfied
Very Satisfied
Not Satisfied
Somewhat Satisfied
Satisfied
Very Satisfied
Not Satisfied
Somewhat Satisfied
Satisfied
Very Satisfied
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33
Referee Facility Conditions
Please drag the slider to make a selection
Referee's Change Room
Referee's Toilets/Showers
Not Satisfied
Somewhat Satisfied
Satisfied
Very Satisfied
Not Satisfied
Somewhat Satisfied
Satisfied
Very Satisfied
Referee's Change Room
Referee's Toilets/Showers
Not Satisfied
Somewhat Satisfied
Satisfied
Very Satisfied
Not Satisfied
Somewhat Satisfied
Satisfied
Very Satisfied
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34
Facility and/or Pitch Comments?
*
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Please provide details if the facility DID NOT conform to any of the Laws of the Game or SWVFA/FV Regulations.
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