Master Agreement 2005 - State Employment Relations Board

Grievance Form
Columbus Public Schools II
GRIEVANCE
(Certificated Teaching Personnel)
Grlev1nt'1Natn1 (Pienel)l'lnt)
Statement of Grievance:
Section of Agreement or Policy, Rule or Procedure claimed to have been violated:
Date, Time and Location of Occurrence:
Relief Requested:
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II
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Q.
IU
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Presented to Principal/Supervisor:
Disposition:
Response Date: ____
Date Gtievant'sSIQnature
Principal/Supervisor
I hereby request that my grievance be forwarded to Step 2.
I
Presented to Principal/Supervisor
I
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...
Q.
IU
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Date received by Superintendent:
Disposition·
Response Date: ____
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GrieYanl'aSfgna!Ure
Superintendent/Designee
~ The Association requests that this grievance be submitted for arbitration.
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a:
Association President/Designee Signature
iii Date Received by Superintendent:
a:
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