Ways and Means Fund (APPEAL)

Ways and Means Fund Appeal Form
The Ways and Means Fund is a pool of money provided by the Employer as per our Collective Agreement and administered by an elected committee of CUPE Local 3903 members. Its mandate is to make funds available to Local members who find themselves in unexpected financial crisis, for example, caused by a death in the family, unforeseen illness (for yourself or dependants), theft and/or legal costs, and other emergency circumstances.

Appeals: To appeal the decision of the Committee, please:
- Provide a rationale as to why you feel the decision should be reviewed,
- Provide any new/additional information or documentation that might support a favourable appeal
- Provide a copy of the original application. Either the auto-generated one via your adjudication result email or a seperate pdf
Upon receipt of an appeal, the application will be anonymized and forwarded to the Executive Committee for consideration.

Email: cupe3903waysandmeans@gmail.com
Original Application
Name as Appears on Membership List (i.e., what York calls you)*

Given Name(s)Surname(s)
Preferred Name (If Different from Membership List)

Given Name(s)Surname(s)
York Employee Number*
This number begins with 100, 101, or 102
Non-York Email*
You will not be able to submit this form if you use a York email address
It looks like you've entered a York email address. Please enter a non-York email address to submit this form.
Submission ID
Can be found within adjudication result email (auto-populated if you followed the link)
Original application*

Please attach original application either (1) provided within adjudication result email or (2) filled in by the member.
Cancelof
Appeal
Rationale for Appeal*
Additional Documentation

Cancelof
Submission
Certificate

I certify that all information presented herein is accurate to the best of my knowledge.
Signature*

Clear
Administrative Use Only
DO NOT USE - Appeal Outcome

Successful; Adjudication revisedUnsuccessful; Original adjudication stands
DO NOT USE - Amount Approved
DO NOT USE - Rationale
Should be Empty:

Ways and Means Fund Appeal Form

Original Application

Appeal

Submission

Administrative Use Only