Topics / Grievances / Grievance Information Form

Name

required

Art/Work Unit

required

Work Email Address

required

Work Phone Number

required

Grade

required

Years at the Office

required

Subject of Possible Grievance

Check all that apply

Please describe the Issue

required

Date of Event/Action prompting grievance

required

POPA Rep contacted, date

POPA Rep name and date contacted, if any

Grievance Information Form