PENNSYLVANIA INTERSCHOLASTIC ATHLETIC ASSOCIATION, INC.
550 GETTYSBURG ROAD, PO BOX 2008
MECHANICSBURG PA 17055-0708
TELEPHONE (717)697-0374 OR (800)382-1392 FAX (717)697-7721

BASKETBALL PLAYER, COACH OR BENCH PERSONNEL DISQUALIFICATION FORM

During the 2002-03 PIAA basketball regular season and post-regular season, a disqualified basketball player, coach and/or team personnel shall not be permitted to participate in the next contest at the same level in accordance with Article XIII, Section 8 of the PIAA By-Laws. Any referee who disqualifies a basketball player, coach and/or team personnel must submit a report. This report is for any member school basketball player, coach and/or team personnel that is disqualified in accordance with National Federation Basketball Rules 10-1-8, 10-3-8; 10-3-8 note, 10-4; 10-4 note, 10-5 penalty modified, 10-5 note, 10-6 penalty. This report must be submitted within 24 hours following the completion of the game.

Name of Disqualified Individual:
 School:
Date of Game:
 Location of Game:
 Time of Game:
Visiting Team:
 PIAA District:
 Visiting Team Final Score:
Home Team:
 PIAA District:
 Home Team Final Score:
Name of Official Who Issued Disqualification:
 Boys or Girls  / Level of Competition:
 

REASON FOR DISQUALIFICATION:

 

Date of Report:
 Your Name:
 Your PIAA District:
Your Email Address:

  • Complete all areas of this form (it cannot be submitted without all fields filled).
  • You will have the opportunity, on subsequent pages, to review and edit your input prior to Final Submission.
  • Your email address is used to return a copy of this form after it is processed.
  • Using your browser, you may print a copy of this form.
  • When all fields are filled, press 'Submit'.