FEDERATION INTERNATIONALE

DE VOLLEYBALL

R-3 DAILY REFEREEING DUTY ROSTER

CITY: HALL: POOL/PHASE

Ville: Salle: DATE: Groupe/Phase

MATCH - Rencontre REFEREES SCORERS LINEJUDGES

1st. Country Sex

No. 1 1 4

2nd.
Assist. 2 Res.

VS Res
3

1st. Country Sex

No. 1 1 4

2nd.
Assist. 2 Res.

VS Res
3

1st. Country Sex

No. 1 1 4

2nd.
Assist. 2 Res.

Res
VS 3

REFEREEING COMMISSION
OF THE COPETITION
Commission d'arbitrage de la compe'tition
PRESIDENT SECRETARY - Secretarie
 FEDERATION INTERNATIONALE
DE VOLLEYBALL

R-3 DAILY REFEREEING DUTY ROSTER

CITY: HALL: POOL/PHASE

Ville: Salle: DATE: Groupe/Phase

MATCH - Rencontre REFEREES SCORERS LINEJUDGES

1st. Country Sex

No. 1 1 4

2nd.
Assist. 2 Res.

VS Res
3

1st. Country Sex

No. 1 1 4

2nd.
Assist. 2 Res.

VS Res
3

1st. Country Sex

No. 1 1 4

2nd.
Assist. 2 Res.

Res
VS 3

1st. Country Sex

No. 1 1 4

2nd.
Assist. 2 Res.

VS Res
3

1st. Country Sex

No. 1 1 4

2nd.
Assist. 2 Res.

Res
VS 3

1st. Country Sex

No. 1 1 4

2nd.
Assist. 2 Res.

Res
VS 3

REFEREEING COMMISSION
OF THE COPETITION
Commission d'arbitrage de la compe'tition
PRESIDENT SECRETARY - Secretarie
COMPETITION NAME FEDERATION INTERNATIONAL DE
(INCLUDING SEXAND CATEGORY) + LOGO TEAM : VOLLEYBALL
Equipe :
FINAL TEAM REGISTRATION
O-2 bis
CODE : INA Inscrption definitive des equipes
MATCHES PLYED
SHIRT-Mailot No

PERSONAL DATA HIGHEST REACH

COMPETITORS FOR NATIONAL TEAM
FAMILY NAME AND FIRST NAME SHIRT NAME BIRTH DATE WEIGHT HEIGHT 2 HANS CLUB TEAM Country WORD
SPIKE
(D/M/Y) (KG) (M/CM) BLOCK CHAMP

1 TEAM MANAGER/Manager de lequipe 3 ASSISTANT-COACH 1

Entraineur-assistant
Signature: 4 ASSISTANT-COACH 2

2 HEAD COACH/entraineur en chef 5 DOKTER CHOICE OF UNIFORMS/Chois des

1
Signature: 6 Masseur 2
3
7 REFEREE
8 ASS. MANAGER
 MATCHES PLYED
FOR NATIONAL TEAM
OLYMPIC
OTHERS
GAMES

CE OF UNIFORMS/Chois des tenues

Competition PGN LIVOLI DIVISI 1 2016
City: UNGARAN
Hall: GOR SG WUJIL REF 1 : MATSURI INTER
Match No.: 30 REF 2 : DADAN NAS
Pool/Phase FINAL
Division PA
Date 13 NOP 16 Time 19:00
Teams vs SMD VS TNI
No. Name No. Name
1 C ADRIYADI ADI NUGROHO © 1 SAEFULLAH FAJRI
2 AJI SETIAWAN 2 C AHMAD SOFYAN RIYADI (C)
3 TRI PRAYITNO 3 L DADAN ALI AMDAD (L)
4 ARIS TRI WICAHYO 4 AGUS PRIYANTO
5 SUWARNO 5 OZI DADAH P.
6 ANDI KRITIYANTO 6 HERYANTO
7 HARIS DWI PRASTYO 7 HARFINDO R.P
8 M. ALFIAN TOFIQ A.N. 8 I PUTU JUNIARTHA
9 EDI FARDIANA 9 MARTONO
10 RULY ARDYANTO 10 HENGKI PUTRA
11 L ANDI PURNOMO (L) 11 IRVAN ADITYA
12 DAYU ARVILAGA 12 AGUNG G.

COACH RUHADI MULYO COACH SONNY ADITYA

ASS COACH 1 M. NASRUDIN ASS COACH 1 FIRMAN
ASS COACH 2 M. KHOLIQ ASS COACH 2
 FEDERATION
INTERNATONALE
DE VOLLEYBALL

MATCH RESULT REPORT

0-4 Rapport de resultat de match

CITY :
Ville : UNGARAN DATE : 13 NOP 16 TIME: 19:00
MATCH HALL: POOL/PHASE : SPECTATORS:
No:
30
Salle:
GOR SG WUJIL Geoupe/Phase :
FINAL Spectateurs:

MATCH RESULT
TEAM: SMD A B A B TEAM: TNI
……………. Sets Won ………………..
No C/L Name of Players No C/L Name of Players
TEAM TEAM
1 C ADRIYADI ADI NUGROHO © Point Won 1 SAEFULLAH FAJRI
A B A B
2 AJI SETIAWAN Sets 2 C AHMAD SOFYAN RIYADI (C)
3 TRI PRAYITNO 1 3 L DADAN ALI AMDAD (L)
4 ARIS TRI WICAHYO 2 4 AGUS PRIYANTO
5 SUWARNO 3 5 OZI DADAH P.
6 ANDI KRITIYANTO 4 6 HERYANTO
7 HARIS DWI PRASTYO 5 7 HARFINDO R.P
8 M. ALFIAN TOFIQ A.N. TOTAL 8 I PUTU JUNIARTHA
9 EDI FARDIANA RUHADI MULYO 1st Coach SONNY ADITYA 9 MARTONO
10 RULY ARDYANTO M. NASRUDIN 2nd Coach FIRMAN 10 HENGKI PUTRA
11 L ANDI PURNOMO (L) 1st Referee MATSURI 11 IRVAN ADITYA
12 DAYU ARVILAGA 2nd Referee DADAN 12 AGUNG G.

STARTING PLAYERS
Substitutes
I II III IV V VI I II III IV V VI SETS I II III IV V VI I II III IV V VI
1
2
3
4
5

GAME JURY MATCH REPORT

HEADLINE : SETS DURATION

Set 1 …. ………min.
MAX TEMPERATURE :------------MAX. HUMIDITY: ----------- Set 2 …. ………min.
REMARKS : Set 3 …. ………min.
Set 4 …. ………min.
Set 5 …. ………min.
DOPING CONTROL(applcable):N'ofplyers drawn: Team A: Team B: Total …. ………min.

Game Jury President

Name & Signature

Distribution of copies : 1st page: to FIVB ( Ref, Sub-Comm. Member), 2nd & 3rd page: one to each team; 4th page: to Organising Committee.
Name of the competition: PGN LIVOLI DIVISI 1 2016
City: UNGARAN Country code: I N A DATE 13 NOP 16 TIME 19:00
FEDERATION INTERNATIONALE
Hall: GOR SG WUJIL Pool/Phase FINAL Match No. 30 A
TEAMS
A DE VOLLEYBALL
or SMD VS TNI or
Division: Women Men X Category: Senior X Junior Youth B B INTERNATIONAL SCORESHEET
Start
time H mn
TEAM A S
R POINTS S
R B TEAM
End
time H mn
POINTS Start
time H mn
TEAM B S
R POINTS S
R A TEAM End
time H mn
POINTS
SERVICE ORDER I II III IV V VI I II III IV V VI I II III IV V VI I II III IV V VI
S S
TEAM LINE-UP

1 13 25 37 1 13 25 37 1 13 25 37 1 13 25 37
2 14 26 38 2 14 26 38 2 14 26 38 2 14 26 38
No. OF STARTING PLAYERS 3 15 27 39 3 15 27 39 3 15 27 39 3 15 27 39

[Link] PLAYER E 4
5
6
16
17
18
28
29
30
40
41
42
4
5
6
16
17
18
28
29
30
40
41
42
E 4
5
6
16
17
18
28
29
30
40
41
42
4
5
6
16
17
18
28
29
30
40
41
42

SUBSTITUTES SCORE AT
T : : : : : :
7
8
19
20
31
32
43
44 : : : : : :
7
8
19
20
31
32
43
44 T : : : : : :
7
8
19
20
31
32
43
44 : : : : : :
7
8
19
20
31
32
43
44
9 21 33 45 9 21 33 45 9 21 33 45 9 21 33 45
CHANGE : : : : : : 10 22 34 46
: : : : : : 10 22 34 46
: : : : : : 10 22 34 46
: : : : : : 10 22 34 46
11 23 35 47 11 23 35 47 11 23 35 47 11 23 35 47
1 5 1 5 1 5 1 5 1 5 1 5
12 24 36 48 1 5 1 5 1 5 1 5 1 5 1 5
12 24 36 48 1 5 1 5 1 5 1 5 1 5 1 5
12 24 36 48 1 5 1 5 1 5 1 5 1 5 1 5
12 24 36 48
1st 5th
2nd 6th 1 2 6 2 6 2 6 2 6 2 6 2 6
"T"
2 6 2 6 2 6 2 6 2 6 2 6
"T" 2 2 6 2 6 2 6 2 6 2 6 2 6
"T"
2 6 2 6 2 6 2 6 2 6 2 6
"T"
SERVICE ROUNDS 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7
3rd 7th : : : :
4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8
4th 8th : : : :
Start
time H mn
TEAM A S
R POINTS S
R B TEAM
End
time H mn
POINTS Start
time H mn
TEAM B S
R POINTS S
R A TEAM
End
time H mn
POINTS
SERVICE ORDER I II III IV V VI I II III IV V VI I II III IV V VI I II III IV V VI
TEAM LINE-UP

No. OF STARTING PLAYERS S 1

2
3
13
14
15
25
26
27
37
38
39
1
2
3
13
14
15
25
26
27
37
38
39
S 1
2
3
13
14
15
25
26
27
37
38
39
1
2
3
13
14
15
25
26
27
37
38
39

[Link] PLAYER E 4
5
6
16
17
18
28
29
30
40
41
42
4
5
6
16
17
18
28
29
30
40
41
42
E 4
5
6
16
17
18
28
29
30
40
41
42
4
5
6
16
17
18
28
29
30
40
41
42

SUBSTITUTES SCORE AT
T : : : : : :
7
8
19
20
31
32
43
44 : : : : : :
7
8
19
20
31
32
43
44 T : : : : : :
7
8
19
20
31
32
43
44 : : : : : :
7
8
19
20
31
32
43
44
9 21 33 45 9 21 33 45 9 21 33 45 9 21 33 45
CHANGE : : : : : : 10 22 34 46
: : : : : : 10 22 34 46
: : : : : : 10 22 34 46
: : : : : : 10 22 34 46
11 23 35 47 11 23 35 47 11 23 35 47 11 23 35 47
1 5 1 5 1 5 1 5 1 5 1 5
12 24 36 48 1 5 1 5 1 5 1 5 1 5 1 5
12 24 36 48 1 5 1 5 1 5 1 5 1 5 1 5
12 24 36 48 1 5 1 5 1 5 1 5 1 5 1 5
12 24 36 48
1st 5th
2nd 6th 3 2 6 2 6 2 6 2 6 2 6 2 6
"T"
2 6 2 6 2 6 2 6 2 6 2 6
"T" 4 2 6 2 6 2 6 2 6 2 6 2 6
"T"
2 6 2 6 2 6 2 6 2 6 2 6
"T"
SERVICE ROUNDS 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7 3 7
3rd 7th : : : :
4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8 4 8
4th 8th : : : :
Start S S End A A

time TEAM R POINTS R TEAM time POINTS TEAM Points at change POINTS or SMD TEAMS TNI or
H mn H mn B B
C
SERVICE ORDER I II III IV V VI 1 I II III IV V VI H I II III IV V VI No. Name of player No. Name of player
TEAM LINE-UP

1 11 21 1 11 21

No. OF STARTING PLAYERS S 2

3
2
3
12
13
22
23
A 2
3
12
13
22
23 1 ADRIYADI ADI NUGROHO © 1 SAEFULLAH FAJRI
N
E
4 14 24 4 14 24
4 5 15 25 5 15 25
[Link] PLAYER
5 6 16 26 G 6 16 26 2 AJI SETIAWAN 2 AHMAD SOFYAN RIYADI (C)
SUBSTITUTES SCORE AT
T : : : : : : 6
7 : : : : : :
7
8
9
17
18
19
27
28
29
E : : : : : :
7
8
9
17
18
19
27
28
29
3 TRI PRAYITNO 4 AGUS PRIYANTO
CHANGE : : : : : : 8
: : : : : :
10 20 30
: : : : : :
10 20 30
4 ARIS TRI WICAHYO 5 OZI DADAH P.
S
1st 4th 5 1 4 1 4 1 4 1 4 1 4 1 4
"T"
1 4 1 4 1 4 1 4 1 4 1 4
"T" I
D
1 4 1 4 1 4 1 4 1 4 1 4
"T" 5 SUWARNO 6 HERYANTO
2 5 2 5 2 5 2 5 2 5 2 5 2 5 2 5 2 5 2 5 2 5 2 5 2 5 2 5 2 5 2 5 2 5 2 5
SERVICE ROUNDS 2nd 5th : : E : 6 ANDI KRITIYANTO 7 HARFINDO R.P
3 6 3 6 3 6 3 6 3 6 3 6 3 6 3 6 3 6 3 6 3 6 3 6 3 6 3 6 3 6 3 6 3 6 3 6
3rd 6th : : : 7 HARIS DWI PRASTYO 8 I PUTU JUNIARTHA

SANCTIONS
IMPROPER REQUEST REMARKS RESULTS 8 M. ALFIAN TOFIQ A.N. 9 MARTONO

TEAM A : TEAM B TEAM A B TEAM 9 EDI FARDIANA 10 HENGKI PUTRA

DISQUALIFICA
WARNING PENALTY EXPULTION TION A "T" S W Points SET(Duration) Points W S "T" 10 RULY ARDYANTO 11 IRVAN ADITYA
OR SET SCORE
W P E B 12 DAYU ARVILAGA 12 AGUNG G.
D
1( )
:
:
2( )
:
: LIBERO PLAYERS "L"
3( )
: APPROVAL 11 ANDI PURNOMO (L) 3 DADAN ALI AMDAD (L)
: REFEREES NAME COUNTRY SIGNATURE
4( )
: 1st MATSURI OFFICIALS
: 2nd DADAN RUHADI MULYO C SONNY ADITYA
5( )
: SCORE M. NASRUDIN AC FIRMAN
: ASSISTANT SCORE Total Set Duration M. KHOLIQ T 0
: 1 2 mn M
LINE JUDGES
: 3 4 Match Starting time Match Ending time Total Match Duration
SIGNATURES
Team Captain Team Captain
…H………...mn …H……....mn ….H………...mn
A B
TO RECORD SANCTIONS: PUT THE CORRESPONDING ABBREVIATION ( No. FOR PLAYER,
C=COACH, AC=ASSISTANT COACH, T=TRAINER, M= MEDICAL ) OR DFOR DELAY SANCTIONS, IN THE TEAM
CAPTAINS
3:
APPROPRIATE COLUM AND INDICATE THE TEAM, THE SET AND THE SCORE AT THE MOMENT OF THE Coach Coach
SANCTION
WINNER
SPECIAL REMARKS: SPECIAL REMARKS: FEDERATION INTERNATIONALE
1st Referee: 2nd Referee: DE VOLLEYBALL

R-4 REFEREEING EVALUANTION

CITY: UNGARAN HALL: GOR SG WUJIL

DATE: 13 NOP 16 TIME: 19:00 POOL/PHASE: FINAL

MATCH No. 30 TEAMS SMD VS TNI SEX PA

SETS POINTS
RESULT: TIME PLAYED:

FUNCTIONS FAMILY NAME, Name CATEGORY COUNTRY

Cand. Inter. FIVB

1st REFEREE MATSURI
Cand. Inter. FIVB
2nd REFEREE DADAN

REFEREEING IRC RGC

DELEGATE:

FINAL EVALUATION
TOTAL POINTS
1st REFEREE 2nd REFEREE
(SEE REVERSE)

SCORE 90 - 100 : VERY GOOD (VG) 75 - 89 : GOOD(G)

EVLUATION KEY
60 - 74 : SUFFICIENT (SUFF) UNDER 60 : INSUFFICIENT
INSTRUCTIONS FOR COMPLETION DURING THE MATCH
. Write the letter "R" (Remark) in the corresponding line in the column of the 1 st or 2nd referee.
. Add the set number ("R1") or an index ("R1") or both ("R11"). MATCH DIFFICULTY EASY(*) MEDIUM (**) TOUGH (***)
. Write explanations or recommendations in the "Remarks" section for the 1 st or 2nd referee.
· For the 1st referee – for each first remark in Section 1, 2 or 3, a minimum of two points must
EVALUATION 1st REFEREE 2nd REFEREE
be deducted from the actual score. If the remark is repeated, a minimum of three points must
be deducted; four points for another repetition, etc. For remarks in Section 4, 5 or 6, a minimum
of one point, then two points, then three points must be deducted. ENGLISH
GOOD SUFF INSUFF GOOD SUFF INSUFF
· For the 2nd referee – for each first remark in any section, a minimum of two points must be KNOWLEDGE
deducted from the actual score. If the remark is repeated, a minimum of three points must be
deducted; four points for another repetition, etc.
· According to your remarks and overall evaluation, award points for each group (1-6). SIGNATURE OF THE GAME
REFEREEING DELEGATE

FIVB Official form R-4/ 19 January 2002

Announcer's Script for match Protocol
Time Time
*IP A *IP B Description
( Court Assistant Marching In )
14' 29'
Hadirin dan Penonton, Inilah Petugas Lapangan

( Team marching in ) Immediately when the teams are lined-up:

Selamat Pagi/Siang/Sore/Malam, Hadirin Sekalian, Selamat Datang di :

Nama Event: PGN LIVOLI Divisi Satu 2016

11' 26' Pertandingan ke: ____ Kami Perkenalkan di sebelah Kanan wasit
dengan kostum tim
Di sebelah Kiri wasit dengan kostum tim
Please rise for the national anthem of: (Team A)
and now the national anthem of: (Team B)
8'30" 12'30" Saat ini kita menyaksikan pemanasan resmi di net
Pertandingan ini dipimpin oleh :
2' 2' Wasit 1 wasit nas/int From
Wasit 2 wasit nas/int From
(Second FANFARE)
Presentation of the starting players. Present first team A – the team on your left side – and then team B. In case
that team A is the host (local) team, present team B first.
Check information with Scorer
A A
OR
B
TEAMS OR
B

No. Name of player No. Name of player

LIBERO PLAYER "L"

HEAD COACH Mr./Ms.

LIM PUAY HWEE C FRANCO LIU F.Y.

Technical Time-Out Pertama/kedua

TTO Technical Time-Out Selesai
TO Time-Out tim ……………….
Sub. Pergantian Pemain tim ….………., Nomor …. keluar, Nomor …… masuk nama ……….

*IP (International Protocol - Alternative A or B)

COPYRIGHT BY HQN_2009
 SET 1 SET 2 SET 3 SET 4 SET 5
LINE - UP SHEET LINE - UP SHEET LINE - UP SHEET LINE - UP SHEET LINE - UP SHEET
R- 5 Fiche de position R- 5 Fiche de position R- 5 Fiche de position R- 5 Fiche de position R- 5 Fiche de position

TEAM TEAM TEAM TEAM TEAM

Equipe GP Equipe GP Equipe GP Equipe GP Equipe GP
IV III II IV III II IV III II IV III II IV III II

V VI I V VI I V VI I V VI I V VI I

SERVICE SERVICE SERVICE SERVICE SERVICE

COACH SIGNATURE COACH SIGNATURE COACH SIGNATURE COACH SIGNATURE COACH SIGNATURE

COPYRIGHT PROLIGA_2016 COPYRIGHT PROLIGA_2016 COPYRIGHT PROLIGA_2016 COPYRIGHT PROLIGA_2016 COPYRIGHT BY HQA_2011

SET 1 SET 2 SET 3 SET 4 SET 5

LINE - UP SHEET LINE - UP SHEET LINE - UP SHEET LINE - UP SHEET LINE - UP SHEET
R- 5 Fiche de position R- 5 Fiche de position R- 5 Fiche de position R- 5 Fiche de position R- 5 Fiche de position

TEAM TEAM TEAM TEAM TEAM

Equipe JPE Equipe JPE Equipe JPE Equipe JPE Equipe GP
IV III II IV III II IV III II IV III II IV III II

V VI I V VI I V VI I V VI I V VI I

SERVICE SERVICE SERVICE SERVICE SERVICE

COACH SIGNATURE COACH SIGNATURE COACH SIGNATURE COACH SIGNATURE COACH SIGNATURE

COPYRIGHT PROLIGA_2016 COPYRIGHT PROLIGA_2016 COPYRIGHT PROLIGA_2016 COPYRIGHT PROLIGA_2016 COPYRIGHT BY HQA_2011
Name of the Competition: PERTAMINA PROLIGA 2016 FEDERATION
City: 0 Country Code: VIE Date 23-Mar-16 Time 16:00 INTERNATIO
Hall: 0 Pool/Phase PENYISIHAN Match No: 16 A TEAMS A DE VOLLEYB
or GP JPE or
Division: Man Women X Category: Senior X Junior Youth B VS B R-6 INTERNATIONAL LIBERO CONTR

SET 1 SET 2 SET 3 SET 4 SET 5

No: A No: B B A A B B A
Lib. Rep. Score Lib. Rep. Score Lib. Rep. Score Lib. Rep. Score Lib. Rep. Score Lib. Rep. Score Lib. Rep. Score Lib. Rep. Score Lib. Rep. Score Lib. Rep. Score

: : : : : : : : : :
: : : : : : : : : :
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: : : : : : : : : :
: : : : : : : : : :
: : : : : : : : : :
HQA_2011

Re-designation team A: Re-designation team B: Remark(s)

No: (OUT/IN) ......../....... Set: Points: : No: (OUT/IN) ......../....... Set: Points: :

Name of the Assistant score: MATSURI Signature:

 FEDERATION
INTERNATIONALE
DE VOLLEYBALL
INTERNATIONAL LIBERO CONTROL SHEET

SET 5

Lib. Rep. Score

:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
: