Step 1 Grievance Form
Date: __________________________________________________   20________

To: (Employer)                                                      From:

___________________________________        Name: ______________________________________

___________________________________        Address: ____________________________________

___________________________________        City/Town: ___________________________________

___________________________________        Province, Postal Code: _________________________

___________________________________        Email Address: ________________________________


Date of Grievance: ________________________________________   20
________

Cause of Grievance:

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

Redress sought:

__________________________________________________________________________________

__________________________________________________________________________________

Signature: ____________________________________________________

Seniority Date: _________________________________________________
Present completed form to your supervisor.  Please ensure you deliver a copy to your Local Chairperson