Score Dispute Complaint Form
Submit your complaint regarding a disputed score. Please provide accurate and complete information to help us review your case.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Score/Event
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type of Score
*
Please Select
Exam/Test
Assignment
Competition
Other
Original Score Received
*
Score You Believe Is Correct
Reason for Dispute
*
Upload Supporting Documents (optional)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Have you contacted the scorer/instructor about this issue?
*
Yes
No
Signature
*
Submit Complaint
Submit Complaint
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