Referee Feedback Form

Your Name*

Your Email*

example@example.com

Club*

Competition*

Date of Match*

Home Team*

Away Team*

Result

Degree of Difficulty

This report refers to the*

Did the referee :

	Yes	No
Arrive no later than 20 minutes prior to the scheduled kick-off?
Present in a tidy and professional manner?

Did the referee (1 = lowest and 4 = highest) :

	1	2	3	4
Protect player safety by correctly interpreting and applying the Laws of The Game?
Make consistent decisions throughout the match?
Deal with similar incidents in a similar way?
Stay close to play to see challenges?
Communicate with players in an effective way?
Have respect for players and team officials?

Any other comments? If including emails from Club Coaches/Managers please upload into this form or email referees@esfa.com.au