HSA 002 - Change of Fixture Application

Change of Fixture Application

HSA 002
This form must be submitted online by both club's secretaries at least 5 days prior to the original or proposed new match fixture.

Note:- The proposed new match fixture must be played before the original fixture time/date or within two weeks after the original fixture date.
Original Game Details
Home Club*
Away Club*
Age Group*
Round*
Match Date *

DayMonthYear
Date
Time*

:HourMinutesAM/PM Option
Venue*
Proposed Game Details
Match Date*

DayMonthYear
Date
Time*

:HourMinutesAM/PM Option
Venue*
Reason for Request*
Submitted by*

First NameLast Name
Club*
Club Position*
Note: Both Clubs involved have to submit this form for the change of fixture to be considered.
Should be Empty: