Grievance Form

Your Name (required)

Your Email (required)

Contact Phone

School (required)

Best Time to Reach You by Phone:

Name of Supervisor/Principal:

Current Assignment:

How Long Have You Been There:

Prior Assignment:

How Many Years Have You Been in District:

Professional Teacher Status:
YesNo

Previous Grievances:

Natures of Current Dispute: (be specific; names, dates, times, places)

Remedy Sought:

List Contract Language That You Feel Has Been Violated:

Date Submitted:

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