REQUIRED REPORT TO CONFERENCE OFFICE OF EJECTION FROM AN ATHLETIC CONTEST

SPORT: ________________________

Teams: _____________________ @ ___________________________

Person(s) ejected and school affiliation:

_____________________________________________________________________

____________________________________________________________________

Witness(es) ___________________________________________________________

_____________________________________________________________________

Date of Incident: ________________ Location: ________________________

Date Reported to AD: ____________ Date Reported to League Office: ____________

Complete description of ejection: __________________________________________

_____________________________________________________________________

____________________________________________________________________

Reported by: ___________________________ Title: ______________________

Date: _______________

Ejection reports are kept on file in the office of the Athletics Director on a yearly basis.


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