USQRA PLAYER CLASSIFICATION PROTEST FORM
(print form and fill in)

Date: ________________________________________________________
Athlete being protested ___________________________________________
Protested Athlete’s Team/ Country Affiliation ___________________________
Current Classification: ____________________________________________
Please circle one of the following .5 1.0 1.5 2.0 2.5 3.0 3.5
Reason (s) for protest (Use additional paper if necessary):
________________________________________________________________
________________________________________________________________
________________________________________________________________

Please enclose $50.00 (USA) protest fee with completed form to:
USQRA Classification Committee c/o Diane Bulger Tsapos, OT
1 Paint Rock Court - Trophy Club, TX 76262

** Protest fee will be refunded if protest is ruled in favor of individual/team protesting.

Original Classification Date:_______________    Current Protest Date:____________________
Classification Panel_____________________     Classification Panel_____________________
Name/Country________________________       Name/Country_______________________
1) Head Classifier_____________________       1) Head Classifier_____________________
2) Classifier         _____________________         2) Classifier          _____________________
3) Classifier         _____________________         3) Classifier          _____________________
PCB-Representative_______________________

Classification Ruling:                  Stands (Classification: ) Overturned (Classification )
Reasons:
________________________________________________________________
________________________________________________________________
________________________________________________________________

Fee Status:             Returned to Protester                                  Date            
                              Returned to USRA Classification Committee       Date