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    Potential Grievance Information Form: (To Be Filled Out by The Grievant)

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    NASE
    This document is a potential grievance form for an employee to fill out. It requests information such as the employee's name, contact details, work history including current and prior assignments, the nature of the dispute including specific details, the contract articles violated, and the remedy sought. The form is to be used internally to file a potential grievance.

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    Potential Grievance Information Form: (To Be Filled Out by The Grievant)

    Uploaded by

    NASE
    188 views2 pages
    This document is a potential grievance form for an employee to fill out. It requests information such as the employee's name, contact details, work history including current and prior assignments, the nature of the dispute including specific details, the contract articles violated, and the remedy sought. The form is to be used internally to file a potential grievance.

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    Grievance Informationform Form

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    Grievanceinformationform.doc

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    This document is a potential grievance form for an employee to fill out. It requests information such as the employee's name, contact details, work history including current and prior assignments, the nature of the dispute including specific details, the contract articles violated, and the remedy sought. The form is to be used internally to file a potential grievance.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    188 views2 pages

    Potential Grievance Information Form: (To Be Filled Out by The Grievant)

    Uploaded by

    NASE
    This document is a potential grievance form for an employee to fill out. It requests information such as the employee's name, contact details, work history including current and prior assignments, the nature of the dispute including specific details, the contract articles violated, and the remedy sought. The form is to be used internally to file a potential grievance.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
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    POTENTIAL GRIEVANCE INFORMATION FORM

    (To be filled out by the Grievant)


    Directions: Please fill out as completely as possible. This form will be used for internal purposes only.
    Name ____________________________________________________

    Sex M _____ F _______

    Home Address _________________________________________

    Home Phone ______________

    School Address _______________________________________

    School Phone _____________

    Personal Email (not work email


    please):________________________________________________________
    Prefer To Be Contacted at: Home ____________School _____________Other (List)________________
    Name of Supervisor/Principal ____________________________________________________________
    Current Assignment _____________________ How Long in Current Assignment __________________
    Prior Assignment _____________________________________________________________________
    If a Teacher: How Many Years Teaching in District?_______ Professional Status Yes______ No_______
    Current Assignment __________________How Long?______ Prior Assignment____________________
    Previous Grievance(s) _________________________________________________________________
    Nature of Dispute (be specific names, dates, times, places, attach additional pages if necessary)
    ____________________________________________________________________________________
    ____________________________________________________________________________________
    ____________________________________________________________________________________
    ____________________________________________________________________________________
    Remedy Sought ______________________________________________________________________
    ____________________________________________________________________________________
    It is mandatory to list specific Article/Sections you feel have been violated:
    ____________________________________________________________________________________
    ____________________________________________________________________________________
    ____________________________________________________________________________________

    __________________________________
    Signature Grievant

    ________________________________
    Date

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