File a Grievance
Aggrieved Employee
First Name
Last Name
PSID
Date Of Occurrence
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Clause of the Contract Violated:
Article
Paragraph
Explanation of Violation
Desired Settlement
Is this being submitted by:
*
Employee
Steward
Submitted By Employee:
*
First Name
Last Name
Submitted By Steward:
*
First Name
Last Name
Email
*
Acknowledged By Supervisor:
*
First Name
Last Name
First Step
First Step Date
-
Month
-
Day
Year
Action
Steward Signature
Supervisor
First Name
Last Name
Submit
Should be Empty: