APPEAL FORM (From September 2015)

Please see the notes overleaf before completing the form and for details of where it should be sent when completed

.

  1. Name of Appellant

  1. Name of any Affiliated Body supporting the appeal

  1. Nature of penalty under appeal
    Please tick one box,
/  - Red Card  - Matchday Misconduct  - Disrepute
  1. Date of incident in question

  1. Details of the penalty imposed

If the appeal is against suspension, please state the number of days and the dates.

  1. Date on which the Penalty Notification Form was received

  1. Nature of the appeal
    Please tick one box
/  - Against the whole decision  - Against the penalty imposed only
  1. Is an oral hearing requested
    Please tick the appropriate box
/  - Yes - No

The appeal will normally be heard on the basis of written submissions only, but an oral hearing can be requested.

  1. Basis of the appeal

  1. Appellants contact for service of documents
/ Address –
Email -
Phone -
  1. Cheque enclosed
    Please tick one box
/  - £100 to Regional Panel  - £150 to National Panel
  1. DECLARATION. I confirm that the contents of this Appeal Notice are true to the best of my knowledge and belief, and that I have read the relevant Regulations. Please see note 1 overleaf

  1. Signed
/ Date:

1. Before completing any part of the Form, please read the relevant Regulations and in particular those sections dealing with appeals. The Regulations can be downloaded from the EH website ( by clicking on the “Equity and Ethics” heading, then following the connection into “Links and Documents”.

2. Having read the appropriate Regulations, please ensure that all aspects of the Appeal Notice are completed, and that alternatives have been deleted as necessary.

3. Please ensure that the Appeal notice form has been signed, dated and that a cheque in respect of the appropriate deposit has been enclosed. For an appeal to an RDAP, the cheque (£100) should be made payable to the Regional Hockey Association concerned eg “East Hockey Association” or “North Hockey Association”. For an appeal to the EH Appeal panel, the cheque (£150) should be made payable to “England Hockey”.

A cheque for the appropriate deposit must be enclosed with the Appeal Notice. Failure to do this will render the appeal null and void

4. When completed, this form should be sent by first class post (or fax/ e-mail if the Appellant is content to use those means of communication) to the relevant Disciplinary Administrator ie:-

- For an appeal against a decision of a County Disciplinary Administrator (CDA) or a Regional Disciplinary Administrator (RDA) , then to the relevant RDA marked “For the attention of the RDAP”; or

- For an appeal against a decision of the National Discipline Panel (NDP), then to the National Discipline Officer marked “For the attention of the EH Appeal Panel”

5. If unclear about any element of the Form, or the postal address of the relevant RDA, please contact the relevant RDA or the NDO for advice

NATIONAL DISCIPLINARY OFFICER / Norman Stott
Tel 01743 350233, Email
UK ARMED FORCES HA / Lt Col Andy Lowe
Tel 07811 390256Email
EAST / Mick Pullin
Tel 01708 226492, Email
MIDLANDS / Andy Barnes
Tel 01636 821643, 07778 747662 Email
NORTH / Chris Kingscott
Tel 01257 473641, Email chris.kingscott@skym tebmer 2014)4).com
SOUTH / Ray Strudwick
Tel 01344 646 364, 07979 844487, Email
WEST / Christy Bergfeld
Tel 01823 680 437, Email