BAN APPEALS/ACTION FORM

BAN APPEALS/ACTION FORM

PLEASE FILL-IN ALL AREAS
Your First Name:*
Your User Name:*
Your Email Address:*
example@example.com
Verify Your Email Address*
Your IP Address:*
You Can Find Your IP Address At https://www.whatismyip.com/
Your Country:*
What Chat Where You Banned From*
What Is Your Rank/Level:*
What Action Was Placed Against You*
Room Extended MuteRoom BlockGlobal MuteKickSite BanNetwork Ban/ Pernament Ban
Room Mutes And Room Blocks- Lis Room
If this does not please type in " N/A.
The Date You Where Banned/ Action Placed Against You?:
Which Chat Where You Banned From/Action Placed:*
Was This The First Time You Where banned:*
Tell Us To The Best Of Your Knowledge, Why You Where Banned:*
File Upload:

Please Supply Us Screen Shots If You Have Them To help Make Our Job Easier.
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File Upload

Extra File Upload
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File Upload

Extra File Upload
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Do You Know Who Banned You:*
If You Know Who Banned You, Please Give Us There Name:
TERMS AND CONDITIONS

All the information I have provided above is accurate to the best of my knowledge. I know if I provide false information willingly and purposely, I will be permanently banned and not able to return to the chat.
Your Signature:*
Date / Time:
Please verify that you are human*
Should be Empty: