Individual Conduct Review Report

ANY REPORTS SUBMITTED ON THIS SURVEYMONKEY FORM THAT ARE BASED ON DISPUTING TECHNICAL CALLS MADE DURING A GAME WILL BE DISREGARDED.

Please note: While personal contact information is required to complete this survey, it will be kept confidential and will not be shared.

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* 1. Please provide your first and last name

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* 2. Please provide your current email address

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* 3. What is the best phone number to reach you at during business hours (if required)?

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* 4. What is your role in soccer in the BSC? Please choose one (the role you were acting in when you saw the conduct you wish to report).

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* 5. Name of Individual you wish to report. This field is MANDATORY, if not completed, the report will be disregarded.

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* 6. Gender of Individual

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* 7. The individual being reported was in the role of:

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* 8. In what event/league/competition did this game take place?

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* 9. Date and Time of Game or Activity

Date
Time

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* 10. Activity Location (field/school/club)

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* 11. Age Group and Gender of game (if in a game environment)

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* 12. In detail, please describe the Conduct you wish to report in the comment field below (please note: we will NOT accept Conduct Reviews on the Technical Calls made by Match Officials during a game)

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* 13. Thank you for taking the time to complete this Conduct Review Form. Please note that these forms are reviewed on a weekly basis by Staff and the Head Match Officials. 

Please select below if you would like to receive a follow up to your concerns.

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