Feb 1, 2007 12:30 PM
STEP 1 GRIEVANCE
School:_________________________________________District:________________________
Name of Grievant_______________________________________________________________
Title (psychologist, social worker, etc.):______________________________________________
File Number:___________________________________________________________________
Date Grievance Occurred:_________________________________________________________
Set forth specifically the act or condition and the grounds on which the grievance is based:
Specific contractual article and section alleged to be violated:
Specific remedy sought:
__________________________________________
(Signature of Grievant)
Date filed:
Grievance Conference
Date:
Attendees:
Name Title
Decision including supporting reason:
____________________________________________
(Signature)
Date: