New Brunswick Rugby Union (NBRU) 2021 Canada Summer Games Selection Criteria

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New Brunswick Rugby Union (NBRU) 2021 Canada Summer Games Selection Criteria
New Brunswick Rugby Union (NBRU)
                     2021 Canada Summer Games Selection Criteria

1. Role of the PSO
The 2021 Canada Summer Games team is a program of the NBRU. The NBRU will manage the Canada
Games program. All plans, budgets and policy updates all must be approved by the NBRU Board of
Directors before being implemented.

The NBRU will oversee the selection of the Coach and the Manager.

The NBRU Technical Director will be the main point of contact for the Head Coach and Manager of the
team.

2. Role of the Coach
The Head Coach is responsible for:
    • Planning and leading the player development program for the identified athletes
    • Maintaining records of player evaluations
    • Working with the manager to oversee the budget for the team program.
    • Providing regular reports to the Technical Director
    • Working with the manager to oversee the code of conduct for the team
    • Team selection with Selection Committee

3. Role of the Manager
The Manager is responsible for:
    • Supporting the head coach in his or her responsibilities
    • Managing team logistics
    • Communication with players and parents
    • Liaison with Team NB Chef, Assistant Chef’s and Mission Staff
    • Record keeping

4. Purpose
The purpose of the 2021 Canada Summer Games program is to promote the development of seven’s
rugby through the development of a strong well-prepared Canada Games team. The team will model
NBRU core values and develop through meaningful competition, camps and training programs.

5. Eligibility
Eligibility for the 2021 Canada Summer Games team is defined in the 2021 Canada Summer Games
Rugby 7s technical package. The team will consist of:
     • 10 athletes, 1 coach and 1 manager
•   Athletes must born in or after the year 2003
     •   Athletes must be fully registered members of NBRU and Rugby Canada
     •   The coach must be certified Competition Introduction

6.   Program Goals
1.   Improved individual performance levels
2.   Field a competitive team at all tournaments leading up to 2021 Canada Summer Games
3.   Field a competitive team at 2021 Canada Summer Games
4.   Have athletes Identified for Regional and National identification camps.

5. The Selection Committee
The Selection Committee will be responsible for the selection of the team. The Committee will be
comprised of the 2021 Canada Summer Games Head Coach, the NBRU Technical Director and the NBRU
High Performance Director.

6. Required Participant Commitment
Athletes must maintain a minimum of 75% attendance to training camps, Academy sessions and
competitions leading up to the 2021 Canada Summer Games. Exemptions may be requested, and if
granted, do not count towards the attendance percentage. Injured players may still be required to
attend practice even if not participating.

7. Participation Exemptions
An athlete may request an exemption from participation in a camp, competition or training event.
Applications must be made to the head coach in advance or as soon as possible after the event (in the
case of an unforeseen circumstance) stating the case for an exemption. The coach may provide
exemptions for injury, illness, family emergency or another reasonable request. Proof of injury or illness
may be required.

8. Selection Process
The selection process for athletes for the 2021 Canada Summer Games is as follows:
    • An open try out in the Fall of 2020
    • Identification of up to 24 athletes for the Canada Games Training Team
    • The training team members will participate in:
            -       a fitness training program,
            -       Canadian Championships and/or Tropical 7s
            -       Regional 7s events
            -       2-4 Training Camps
            -       NBRU Academy Training sessions

Should an athlete be identified or express interest in becoming part of the team post Fall 2020, the
Selection Committee at their discretion, may add the player to the training group on a permanent or try-
out basis.

Following the final event in April of 2021, 10 athletes and 2 alternates will be selected. This final
selection will take place May 1st, 2021.
9. Selection Criteria
Athletes will be assessed based on four major components: Skill, Fitness, Game Play and Character (see
Appendices A and B). The assessment process will begin with the identification camp in the fall of 2020
and end at the final selection event in April 2021.

Final selection will be completed by the Selection Committee. The Committee will consider the above
assessments to produce the team that is best able to achieve the goals of the program. This includes
consideration of the need to fill various roles on the team, positional strengths, versatility as well as
intangibles that include but are not limited to: long term/National team potential, leadership, attitude
and desire.

10. Alternates
The two alternates selected are not part of the Canada Games team, do not travel to the Games and are
not part of Team New Brunswick. Should a selected athlete need to be replaced due to injury, illness,
lack of commitment, code of conduct violation, resignation or other reason, one of the alternates will be
selected to replace her. The decision on which alternate is to be selected will be made by the Selection
Committee and based on the needs of the team.

Should an alternate be placed on the team, an additional player may be added as a second alternate.

11. Code of Conduct
All athletes, coaches and managers must review and sign the NBRU Code of Conduct (see appendix C).
An athlete may be removed at any point of the selection process if they do not comply to Code of
Conduct.

12. Deselection
Following final selection athletes must maintain fitness and performance standards, if not the coach
may recommend to the selection committee the deselection of the athlete.

13. Appeals
Any athlete who is impacted by a decision of the coach, selection committee or the NBRU, is entitled to
lodge an appeal. Appeals must be made in writing within 48 hours of the decision being made by
contacting the President of the NBRU. The Appeals Policy is included in Appendix D.
Appendix A – Athlete Code of Conduct

This code shall apply to all players who are registered members of New Brunswick Rugby Union.
All players shall:
    • ensure that the Game is played and conducted in accordance with the principles of
        disciplined and sporting behaviour and in a safe and proper environment;
    • acknowledge that it is not sufficient to rely solely upon the Match Officials to maintain
        the above principles or environment;
    • co-operate in ensuring that Laws of the Game are upheld;
    • accept and observe the authority of all Match Officials;
    • treat match opponents with respect
    • not engage in any conduct or activity on or off the field of play that may impair public
        confidence or may bring the reputation of the Game into disrepute;
    • abide by all New Brunswick Rugby Union policies
    • actively promote and protect the reputation of the Game;
    • not abuse, threaten or intimidate any match official, spectator, organizer or player,
        whether on or off the field of play;
    • not do or say anything which is likely to intimidate, offend, insult, humiliate or
        discriminate arbitrarily against any other person on the grounds of their religion, race,
        colour, sex, size, physical or mental characteristics or national or ethnic origin or do
        anything which is likely to be perceived as harassment
    • Communicate and cooperate fully with registered medical personnel in the diagnosis,
        treatment and management of injuries incurred by athletes.
    • Consider the athlete’s future health foremost in decisions regarding an injured player
        continuing to participate in an activity.

I understand the above required conduct and expectations, and I agree to conduct myself
accordingly.

____________________________________                _______________________________________
             Signature                                           Print Name

____________________________________                _______________________________________
               Date                                              Club/Team
Appendix B - Coaches and Managers Code of Conduct
The coach/athlete relationship provides unique opportunities for the development of values
and personal growth for provincial representative athletes.

Coaches and Managers agree to:
   • Treat everyone fairly and equally regardless of gender, race, sexual orientation, religion
      or economic status.
   • Consistently display high personal standards and project a positive image of rugby.
   • Refrain from any public criticism of NB athletes, other NB coaches or New Brunswick
      Rugby Union.
   • Refrain from use of profane, insulting, harassing or any offensive language or behavior
      while in a coaching role.
   • Ensure that all activities for players are safely organized and are appropriate for the age
      level, experience level, and level of fitness for each athlete
   • Communicate and cooperate fully with registered medical personnel in the diagnosis,
      treatment and management of injuries incurred by athletes.
   • Consider the athlete’s future health foremost in decisions regarding an injured player
      continuing to participate in an activity.
   • Treat opponents and game officials with respect and ensure athletes to do the same.
   • Communicate with parents about behavioral expectations of them towards opposition
      and game officials.
   • Actively encourage athletes to uphold the rules of rugby and demonstrate
      sportsmanship.
   • At no time become intimately and/or sexually involved with athletes.
   • Discourage any use of drugs or banned performance enhancing substances.
   • Refrain from any actions that could inappropriately influence athlete decision-making
      about future participation at post-secondary or club rugby levels.

I understand the above required conduct and expectations, and I agree to conduct myself
accordingly.

____________________________________                _______________________________________
             Signature                                           Print Name

____________________________________                _______________________________________
               Date                                              Club/Team
Appendix C – THE NBRU Provincial Team Appeal Policy

1.0   Pre-Amble
      1.1   The NBRU recognizes the right of any Member to appeal the decisions of the NBRU and
            hereby provides for an appropriate process to resolve disputes that could arise from
            time to time from these decisions.
      1.2   The purpose of this appeal policy is to allow disputes between the NBRU and its
            Members to be dealt with fairly, expeditiously and affordably within the NBRU, without
            requiring recourse to formal legal and court-like procedures.
      1.3   In this policy, unless context otherwise requires, words in singular include the plural and
            vice versa; words importing gender include all genders.

2.0   Definitions
      2.1     Appeal Committee Chair: Refers to an impartial individual nominated by the NBRU to
              oversee only the application of the process described in this policy;
      2.2     Appeal Committee: Refers to the Appeal Committee established as provided by section
              11;
      2.3     Appellant (also referred to as “Party”): Refers to a Member appealing a decision of the
              NBRU;
      2.4     Days: Means total days, irrespective of weekends or holidays;
      2.5     Interested Party (also referred to as “Party”): Refers to an individual who can be
              directly affected or impacted by a decision of the Appeal Committee and:
              •       Is accepted as such by the Parties; or
              •       Is accepted or named as such by the Appeal Committee;
      2.6     Member: Refers to all categories of members of the NBRU, as well as to all individuals
              engaged in activities with or employed by the NBRU, including, but not limited to,
              athletes, coaches, officials, volunteers, directors, officers, team managers and
              employees including contract personnel;
      2.7     Notice of Appeal: Refers to a notice filed by the Appellant through the form attached;
      2.8     Respondent (also referred to as “Party”): Refers to the body, person or persons whose
              decision is being appealed;
      2.9     Statement: Refers to the written response submitted by the Respondent through the
              form attached;
      2.10    Working Days: Means total days, excluding weekends and holidays.

3.0   Scope of the Appeal
      3.1    Any Member of the NBRU who is affected by a decision related to the provincial team
             program will have the right to appeal that decision, provided there are sufficient
             grounds for the appeal, as set out in section 4. Any member under the age of 19 years
             may have their interests represented by a parent, guardian or other advocate. Typical
             Appeal include non-selection to teams, non-selection to coaching staff, dismissal from
             program and ruled ineligibility of athletes.
4.0     Grounds for an Appeal
An Appellant cannot challenge a decision only on the grounds that it is not favorable to him or her. An
appeal may be heard only if there are sufficient grounds for the appeal. Sufficient grounds include, but
are not limited to, the Respondent:
        4.1      Making a decision for which it did not have authority or jurisdiction as set out in
                 provincial team policies;
        4.2      Failing to follow procedures as laid out in the bylaws or approved policies of THE NBRU;
        4.3      Making a decision which was influenced by bias, where bias is defined as a lack of
                 neutrality to such an extent that the decision-maker is unable to consider other views
                 and/or that the decision was made on the basis of, or significantly influenced by, factors
                 unrelated to the merits of the matter;
        4.4      Exercising its discretion for an improper purpose; and/or
        4.5      Making a decision that was unreasonable or unfair.

5.0     Timing
        5.1    Members who wish to appeal a decision will have seven (7) days from the date they
               received notice of the decision, to submit their Notice of Appeal to the Appeal
               Committee Chair.
        5.2    Any Member wishing to submit the Notice of Appeal beyond the 7-day period must
               provide a written request stating reasons for an exemption to the requirement of sub-
               section 5.1.
        5.3    The decisions to allow or refuse the exemption as provided by sub-section 5.2 will be at
               the discretion of the Appeal Committee as established in accordance with section 11.
        5.4    Other timelines provided for in this policy can be amended by the Appeal Committee
               Chair or the Appeal Committee when justified by the circumstances.

6.0     Filing Notice of Appeal
        6.1     Members who wish to appeal a decision of the NBRU that affects them must initiate the
                appeal process by filing the Notice of Appeal (see Attached) with the Appeal Committee
                Chair. The appeal process cannot begin until this application is made.
        6.2     The Notice of Appeal form shall include:
                •        The name of the Appellant and his coordinates;
                •        The name of the Respondent;
                •        The decision being appealed and related facts;
                •        The grounds for the appeal;
                •        A summary of the evidence supporting the grounds, including a list of witnesses
                         and the evidence to which they will testify;
                •        The remedy sought or solutions proposed by the Appellant;
                •        The potential Interested Parties, if known by the Appellant;
                •        The name of the Appellant’s representative and his coordinates, if applicable;
                •        The language requested for the proceedings; and
                •        If applicable, the request for timing-exemption with justification.
                •        Upon receiving the Notice of Appeal, the Appeal Committee Chair will contact
                         the Appellant if the notice is incomplete or to seek clarifications.
7.0   Initial Screening of Appeal
      7.1      Upon receipt of the documents relating to the appeal, the Appeal Committee Chair will
               decide whether the request is admissible with regards to:
               •        The Appellant is a Member of the NBRU as defined in section 2;
               •        The deadline for filing the Notice of Appeal has been met or, where applicable,
                        the exemption request is granted; and
               •        The grounds of appeal set out in the Notice of Appeal are among those
                        mentioned in sub-section 4.1.
      7.2      The facts as alleged by the Appellant in the Notice of Appeal shall be presumed to be
               correct unless such facts are, to the knowledge of the Appeal Committee Chair, clearly
               erroneous.
      7.3      If the appeal is denied on the basis of insufficient grounds, the Appellant will be notified
               in writing, within two (2) working days from the receipt of the Notice of Appeal, of this
               decision and its reasons.
      7.4      If the Appellant believes the Appeal Committee Chair erred in denying his right to
               appeal a decision, the decision of the Appeal Committee Chair may be referred to an
               external appeal in accordance with section 17.

8.0   Notification of the Appeal and Statement by the Respondent
      8.1     If the appeal is deemed admissible, the Appeal Committee Chair will forward a copy of
              the Notice of Appeal to the Respondent within a delay of no more than one (1) working
              day and request a written Statement (see Attached) by the Respondent briefly outlining
              the justification for the decision or the practice being appealed.
      8.2     The Statement will contain:
              •         A summary of facts relating to the matter;
              •         A summary of the evidence supporting the Respondent’s case, including a list of
                        witnesses and the evidence to which they will testify;
              •         Solutions proposed by the Respondent;
              •         The potential Interested Parties and their coordinates, if applicable;
              •         The name of the Respondent’s representative and his coordinates, if applicable;
                        and
              •         The language requested for the proceedings, if applicable.
      8.3     The written Statement, complete et signed, shall be forwarded to the Appeal
              Committee Chair within five (5) working days from the date of receipt of the Appeal
              Committee Chair request or such shorter or longer period as the Appeal Committee
              Chair may specify depending on the urgency of the matter.
      8.4     The Appeal Committee Chair +must forward a copy of the written Statement to the
              Appellant without delay after receipt.
      8.5     Should the Respondent submit an incomplete Statement or fail to submit the Statement
              in writing within the time-limit provided by sub-section 8.3, the Appeal Committee Chair
              will initiate the establishment of the Appeal Committee, without further delay and
              without any attempt to settle amicably, and will notify the Parties accordingly.

9.0   Amicable Settlement of a Dispute
      9.1    The Appeal Committee Chair may invite the Appellant and the Respondent to settle
             their dispute through amicable conciliation by convening a meeting with a neutral third
             party. This neutral third party could be appointed from the list of volunteers to facilitate
an informal discussion between the Parties and reach an agreement, while focusing on
               effective communication and the Parties’ interests.
       9.2     The Parties shall cooperate with the neutral third party and attempt to resolve the
               dispute until either Party terminates the process and/or the neutral third party decides
               that additional discussions are of little use.
       9.3     If the dispute is later submitted to an appeal process, the neutral third party will not
               prepare any report on the discussions held between the Parties and no evidence from
               these discussions is admissible in a subsequent appeal unless the Parties agree to
               submit a joint statement of facts to the Appeal Committee.
       9.4     In an urgent case and when justified by the circumstances, the Appeal Committee Chair
               in its sole discretion may proceed by way of a formal appeal and waive the requirement
               for amicable settlement of the dispute.

10.0   Identification of Interested Parties
       10.1 Upon receipt of the Statement of the Respondent, the Appeal Committee Chair must
                notify potential Interested Parties of the existence of the appeal and invite them to take
                part in the proceedings.
       10.2 The Interested Parties thus invited become Parties to the proceedings and therefore
                have the same rights as the Appellant and the Respondent to make submissions before
                the Appeal Committee with respect to the issues in dispute.

11.0   Appeal Committee
       11.1 Within no more than seven (7) working days of having received the Notice of Appeal,
              the Appeal Committee Chair will initiate the establishment of an Appeal Committee as
              follows:
              11.1.1 The Appeal Committee must include three persons all of whom must be free
                       from any actual or perceived bias or conflict of interest. Being a “peer” of the
                       Appellant or the Respondent should not in itself constitute bias or conflict of
                       interest.
              11.1.2 All three members of the Committee must be nominated must have no
                       significant relationship with the Parties involved; or have had any involvement
                       whatsoever with the decision being appealed; and
       11.2 As soon as they are confirmed, the members of the Appeal Committee will be provided
              with a copy of the Notice of Appeal and the Respondent’s written Statement as well as
              any other exhibits filed by the Parties in support of their respective positions.

12.0   Preliminary Conference
       12.1 Within no more than five (5) working days of the Appeal Committee being established,
               the Committee will hold a preliminary conference to consider various preliminary issues,
               such as, but not limited to, the following:
               •       Date and location of the hearing;
               •       Timelines for exchange of documents;
               •       Format of the appeal (written or oral submissions or a combination of both);
               •       Clarification of the issues in dispute;
               •       Clarification of evidence to be presented to the Appeal Committee;
               •       Order and procedure of the hearing;
               •       Any procedural matters;
•        Clarification of remedies sought; and
              •        Any other matter that may assist in expediting the appeal proceedings.
       12.2   The preliminary conference can be held by conference-call or, depending on the
              circumstances, in person. This decision is at the sole discretion of the Chairperson and
              may not be appealed.
       12.3   The participants in the preliminary conference shall be all Parties, their representatives,
              if any, and the Appeal Committee members.
       12.4   The chairperson shall arrange the preliminary conference and its precise date and time
              in consultation with the participants.
       12.5   The Appeal Committee may delegate to its chairperson the authority to deal with these
              preliminary matters.
       12.6   The Appeal Committee Chair shall assign a committee member or neutral staff/board
              member to take minutes of the preliminary conference and prepare a written
              confirmation of the appeal procedures established during that preliminary conference.
              Within two (2) working days after the conclusion of the preliminary conference, the
              Appeal Committee Chair will communicate to all Parties the written confirmation as
              approved by the Appeal Committee.

13.0   Procedure of the Appeal
       13.1 The Appellant has the burden of proof in an appeal and must prove, on a balance of
              probabilities that the decision being appealed is the result of a procedural error as
              described in section 4.
       13.2 The Appeal Committee shall govern the hearing by such procedures as it deems
              appropriate, provided that the following directives be applied:
       13.3 The appeal shall be heard as quickly as reasonably possible, having regard to the nature
              of the appeal, and the circumstances of the case;
       13.4 All three members of the Appeal Committee shall hear the appeal, but a majority in
              favour of the same result shall be sufficient to effect a decision;
       13.5 Each party shall have the right to be represented at the hearing;
       13.6 Copies of any written documents which any of the Parties would like the Appeal
              Committee to consider shall be provided to the Committee, and to all Parties, within the
              time limits established during the preliminary conference or by the Committee;
       13.7 The appeal may proceed on the basis of written submissions and documentation if all
              Parties to the appeal consent, as long as all Parties are provided a reasonable
              opportunity to present their written submissions to the Appeal Committee, to review
              the written submissions of the other Parties as well as to provide a written reply and
              statement;
       13.8 If the decision of the Appeal Committee may affect another person to the extent that
              the other person would have recourse to an appeal in its own right under this policy,
              that person will become a Party to the appeal in question and will be bound by its
              outcome. The Appeal Committee shall advise Members who can be affected by its
              decision and invite them to file submissions;
       13.9 The Appeal Committee may direct that any other person or party participate in the
              appeal;
       13.10 For sake of expediency and cost reduction, a hearing either by way of written
              submissions, or via telephone or video conference is permissible with such safeguards as
              the Appeal Committee considers necessary to protect the interests of the Parties; and
13.11 Unless otherwise agreed by the Parties, there shall be no communication between
             Appeal Committee members and the Parties except in the presence of, or by copy to the
             other Parties.

14.0   Rules of Evidence
       14.1 As a general rule, the Appeal Committee will only consider evidence that was before the
               original decision-maker. At its discretion, the Committee may also hear new material
               evidence that was not available at the time of the original decision.
       14.2 Unless a Party can prove that it could not possibly have been aware of a fact or
               argument at the time of filing its evidence or submissions, the Appeal Committee should
               not accept any other argument or information from the Parties after the close of the
               submission period established at the preliminary conference, with the exception of oral
               submissions of witnesses at the hearing.
       14.3 The Appeal Committee will determine if an additional element of proof should be
               admitted or rejected after the close of the submission period, as long as all other Parties
               are permitted to reply to any new element admitted.

15.0   Appeal Decision
       15.1 Within three (3) working days of the conclusion the hearing, the Appeal Committee will
              issue its written decision, with reasons. In making its decision, the Committee will have
              no greater authority than that of the original decision-maker. The Appeal Committee
              cannot amend a policy, rewrite selection criteria or insert new clauses into a contract.
              The Committee may decide:
               •       To reject the appeal and confirm the decision being appealed;
               •       To uphold the appeal and refer the matter back to the initial decision-maker for
                       a new decision; and/or
               •       To uphold the appeal and vary the decision where it is found that an error
                       occurred and such an error cannot be corrected by the original decision-maker
                       for reason of lack of clear procedure, lack of time, or lack of neutrality.
       15.2    A copy of the decision will be provided to each of the Parties.
       15.3    In extraordinary circumstances, the Appeal Committee may issue an oral decision or a
               summary written decision, with reasons to follow, provided that the written reasons are
               rendered within the timelines specified in Sub-section 15.1.

16.0   Conclusion
       16.1 Any final decision made by the Appeal Committee that may lead to irreversible
              consequences for one of the Parties may be exclusively submitted by way of application to
              the Sport Dispute Resolution Centre of Canada (SDRCC) or similar body, which will resolve
              the dispute definitively in accordance with the Canadian Sport Dispute Resolution Code,
              as amended from time to time by the SDRCC.
Notice of Appeal

 Date:
                               DD           MM            YYYY

Appellant
 Name:
 Address:
 Telephone (home):
 Telephone (office):
 Telephone (cell.):
 Email:
 Date of birth:
                                DD            MM            YYYY

Representative of the Appellant (if applicable)
Note: An adult representative is mandatory for any Appellant who is a minor in the province where the proceedings
are held.
 Name:
 Address:
 Telephone (home):
 Telephone (office):
 Telephone (cell.):
 Email:

Decision
What decision do you wish to appeal?

 When was that decision rendered?
                                                          DD            MM            YYYY

Respondent
Who made the decision that you wish to appeal?

What are the grounds for your appeal?
Please summarize the evidence that supports these grounds. Attach any evidence that you wish to be considered
(documents, pictures, rules and by-laws, audio-visual material, etc.)

Witness(es)
For each witness, please provide the following information (if there is more than one witness, please attach the
information to the form):

 Name:
 Telephone1:
 Telephone2:
 Email:
Summary of evidence to be provided by this witness:

Recourse
What measure or decision do you ask THE NBRU to take or make to correct the situation?

Exemption
If the decision was rendered more than 7 days ago, why are you filing this Notice of Appeal form beyond the 7 days
time limit as provided by THE NBRU’s Appeal Policy (Section 5)?

Signature
 Signature:
 Name (print):
 Date:
                                 DD            MM            YYYY
Statement of the Respondent

 Date:
                               DD            MM            YYYY

Respondent
 Name:
 Address:
 Telephone (home):
 Telephone (office):
 Telephone (cell.):
 Email:

Justification
Please provide:
     1. Justification for the decision or practice being appealed (reasons); and
     2. Summary of the evidence that supports this justification (documents, pictures, rules and by-laws, audio-
          visual material, etc.)

Interested Party(ies)
Please provide, to the best of your knowledge, the name and contact information of any person whose selection,
or other status could be affected by the decision. Please also indicate the reasons why this person might be
affected by the outcome of the procedure. For each Interested Party, please provide the following information (if
more than one Interested Party, please attach the information to the form):

 Name:
 Telephone1:
 Telephone2:
 Email:
Reasons why this person could be affected:
Witness(es)
For each witness, please provide the following information (if there is more than one witness, please attach the
information to the form):
 Name:
 Telephone1:
 Telephone2:
 Email:
Summary of evidence to be provided by this witness:

Signature
 Signature:
 Name (print):
 Function/Title:
 Date:
                                 DD            MM            YYYY
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