CWA Grievance Form

Bargained Unit* This field is required.

ATT Core

ATT Network Addendum (Wire Technicians)

ATT Mobility

ATT Utility OPS

StewardEnter if you are a steward completing this form or you have given to a steward already

First Name

Last Name

Grievant Name and UID* This field is required.

Last Name

First Name

Company UID

Personal Contact Information* This field is required.Personal Information only. No Company contact information.

Home phone

Cell phone

Email Address

Work Location* This field is required.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Work Information* This field is required.please fill out correctly

Department

Title

Supervisors Name

Work Phone

Seniority Date

NCS Date

Date Of Occurrence* This field is required.

Date

Contract Article Violated* This field is required.make sure this is filled out correctly if you cannot figure it out get in touch with your steward!

Type of Entry* This field is required.

Verbal

Counseling

Warning

Final Written Warning

Suspension/Letter in Lieu

Other/None

Statement of Facts Concerning The Grievance* This field is required.who, what,when,where,and why.

Signature* This field is required.In the event that your home address changes, you must notify your CWA Local in order to receive correspondence regarding this grievance.

Clear

Signature* This field is required.I hereby give consent to the inspection by any authorized Union Representative of any records kept by the Company which may affect the conditions of my employment, which may include Security Reports, Medical Records or Opinions, Police Reports, Court Records or Reports, or any other information which may be relevant and necessary to allow the Union to protect my rights under the Working Agreement between the Union and the Company. This authorization is given in accordance with the existing agreement between the Union and the Company.

Clear

Take Photo of what the company gives youRF31-81-B

CWA Grievance Form