IEAC Ejection Form

Email Secondary Email

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Filled out by *

Game Official Athletic Director

Name of person filling out form *

Email address *

Cell Phone Number *

Sport *

Season / Segment of Sport

Non-Conference Conference Post- Conference Non-Traditional Schedule

Date of Ejection *

Date Picker

Home Team

Away Team

Host Team Tournament

Name of person ejected? *

Uniform Number (if any)?

Ejected Participant *

Player Head Coach Assistant Coach Support Staff Other Spectator

Which College was the ejected person representing? *

Ejected for? *

Physical Abuse Verbal Abuse Assaulting Official Leaving Bench Area Tobacco / Substance Abuse Rule Book Ejection Other (please explain below) Disrespectful Contact Threat of Physical Intimidation

Other if you selected 'other' above

Will your college follow up with any further action(s)? If so, what action(s) will be taken?

Any participant ejected from a contest must sit out the rest of that contest and is suspended from at least the next contest.

Next opponent of the player (s) ejected? *

Next Athletic Director who the ejected player and team will be playing? They will be notified. *

Date Filed

Date Picker

* required field