REQUEST FOR �TEAM NO SHOW� PAYMENT

Name:___________________________________ Phone:__________________

Address:_________________________________ City:________________ Zip:___________


I reported for the following game and received no payment:

Date:____________ Field:___________________ Time:_________ Level:_________

for the following reason:

_____TEAM DID NOT SHOW (Explain)____________________________________________

_____TEAM HAD LESS THAN SEVEN PLAYERS (Explain)____________________________

_____FIELD UNPLAYABLE (Explain)______________________________________________

_____OTHER (Explain)___________________________________________________________

**********

MY ASSIGNMENT WAS:_______________________________________________________

PAYMENT DUE IS:___________________________

MY PARTNERS WERE:

NAME:______________________________ POSITION:____________________

NAME:______________________________ POSITION:____________________

COMMENTS:



___________________________________________________
  date                  Signature

Send to:
ROSRA
503 Melody Court
Royal Oak, MI  48073
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