Nomination Dispute Form
Submit your dispute regarding a nomination. Please provide detailed information to help us review your case thoroughly.
Your Full Name
*
First Name
Last Name
Your Email Address
*
example@example.com
Your Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to the Nominee
*
Please Select
Self
Colleague
Supervisor/Manager
Friend
Other
Nominee's Full Name (person whose nomination is being disputed)
*
First Name
Last Name
Nomination Category or Title
*
Date of Nomination
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Dispute (please provide a detailed explanation)
*
Please select the main grounds for your dispute
*
Eligibility concerns
Incorrect information in nomination
Conflict of interest
Violation of rules or guidelines
Other
Upload Supporting Evidence or Documents (if any)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Signature (please sign to confirm your submission)
*
Date of Submission
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Dispute
Submit Dispute
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