Workplace Complaint & Grievance Report

REPORTER

Who is reporting?

Reporter Mobile Phone *

Home Email of Reporter *

Are you a a Steward?

Yes

ISSUE/INCIDENT

What happened or is happening? *

Describe incidents which gave rise to the grievance.

Name and classification of involved employee(s). * Grievant

Is involved employee in probation period?

Yes

When did this occurr?

Month

Day

Year

Employee Mobile Phone *

Employee Home Email *

LOCATION

Department and unit of incident.

Building/Space where incident occurred.

Name and title of employee's supervisor *

Provide union contract article(s) subject to violation.

Additional comments and recommended corrective actions management should take.