FILE: GAEA-E2
GRIEVANCE APPEAL
INSTRUCTIONS: Complete four copies of this form. Send the original to the next highest authority to hear the grievance. Send one copy to your supervisor, one copy to the Personnel Office and retain one copy for your records. Appeal must be within the specified time limits. If you have any questions, see your supervisor.
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Employee's Name Title Date of Grievance Initiation
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Department (School) Division Location
1. I wish to appeal the grievance disposition signed by: (see Grievance Disposition Form)
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Name Title Date
2. Give nature of grievance:
3. What agreement, policy, regulation, or law do you think has been violated?
4. Reason for the appeal:
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Employee's Signature Date
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Form #
Distribution:
Original - Supervisor
Copy - Employee
Washington Parish School Board