Appendix E
THE CALIFORNIA STATE UNIVERSITY
GRIEVANCE PROCEDURE FORM
UNIT 4
GRIEVANCE PROCEDURE FORM
UNIT 4
LEVEL OF FILING | DATE OF FILING | Campus:__________ |
Level I – President ____________________________
Level II – Labor Relations, _________________________
Office of the Chancellor
GRIEVANT'S NAME | CLASSIFICATION | CAMPUS TELEPHONE NUMBER |
Specific term of agreement alleged violated (provide Unit 4 contract provision number):
Detailed description of the grounds of the grievance (include dates, places, times, etc.):
(If more space is needed, additional sheets may be attached.)
Proposed remedy:
Proposed remedy:
Grievant’s signature:
Grievant’s address:
Name of representative:
Representative’s address and telephone number:
Response
Level I /_/ Level II /_/
Level I /_/ Level II /_/
Signature:_______________ | Title:_______________ | Date:_______________ |
Please provide one copy of each grievance filing or response to: a) employee; b) Employer (level of filing); c) Labor Relations, Office of the Chancellor, 401 Golden Shore, Long Beach, CA 90802; d) employee’s representative.
(Revised 2005)