Grievance form



Fort Hays State University

Faculty Unit

Step 1 Informal Grievance Form

|Grievant: | |Date: | |

| | | | |

|Department: | |AAUP Grievance | |

| | |Representative: | |

| | | | |

|Mailing Address: | |Mailing Address: | |

| | | | |

|Article(s) and Section(s) of Agreement violated: | |

|(Be Specific) | |

Statement of grievance (including date of acts or omissions complained of): Use back of this form, and/or attach additional sheets as necessary.

Redress sought:

I will be represented in this grievance by: (check one)

□ AAUP □ Myself

AAUP grievance representative’s signature:

(If AAUP is representing the grievant, an authorized AAUP representative must sign here).

This grievance was filed with the Chair or Administration of Department on the ______ day of , 20___, by: (check one)

□ Mail □ Personal Delivery

Signature of Grievant

|Date Received: | | | |Grievance Number: | |

| | |By: | | | |

| | | | | | |

|Distribution |Original |1st Copy |2nd Copy |

|Step 1 |Administrator whose action or decision is |Grievant |AAUP |

| |being contested | | |

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