Association of Flight Attendants

May 19, 2013

Grievance Form

First name:
Last Name:
Employee ID#:
Address:
Phone Number:
E-mail:
Pay Rate:	/hour
Domicile:
Date of Hire:	YYYY-MM-DD
Inflight Supervisor Contacted:
Date of Contact:	YYYY-MM-DD
Outcome of discussion with Supervisor
Employee Statement:	Describe in detail the action giving rise to the complaint. Be as specific as possible so AFA can determine the merit for a possible grievance. Please indicate if you have supporting documents or attachments
Please specifcy the section of the AFA Contract that supports your claim:	Article and Page Number:
	I hereby authorize the Association of Flight Attendnants (AFA-CWA) and/or it's representatives to act on my behalf in the disposition, discussion, and resolution of thie grievance. Furthermore, as my representative, the AFA is hereby granted full access to any and all confidential employee files including but not limited to Inflight Supervisor's files and notes, confidential employee files, disciplinary notices or letters of reprimand, regardless of format (i.e. electronic or written) relevant to this complaint. Sign and Date: Name: Date: YYYY-MM-DD