Grievance Fact Sheet

Name (Grievor)

Seniority (Grievor)

Full/Part Time or Probationary (Grievor)

Wage Rate (Grievor)

Name (Management)

DepartmentName (Management)

Job TitleName (Management)

Name (Witness 1)

Department (Witness 1)

Classification (Witness 1)

Name (Witness 2)

Department (Witness 2)

Classification (Witness 2)

Name (Witness 3)

Department (Witness 3)

Classification (Witness 3)

Which

What

When

Where

Why

Want

Warnings and/or penalties for lateness, absenteeism, quantity or quality of work etc.

Verbal Warnings Issued

Written Warnings Issued

Penalties Imposed

Related Information

Information Given By Witnesses

Date

Signature of Steward

Signature of Aggrieved Employee

Forms