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Sample Association Grievance File Grievance # ______________________________________ ____________________________ School District Building Assignment Name of Grievant Date Filed AR Handbook – 39 Step 1 A. Date Cause of Grievance Occurred _____________________________________________ _____________________________________________ _____________________________________________ B. 1 State of Grievance _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ 2 Relief Sought _____________________________________________ _____________________________________________ _____________________________________________ (If more space is needed for Sections B1 & 2, attach an additional sheet.) C. Disposition by Principal or Immediate Superior _____________________________________________ _____________________________________________ _____________________________________________ D. Position of Grievant and/or Association _____________________________________________ _____________________________________________ _____________________________________________ Step 2 A. Date Received by Superintendent/Designee _____________________________________________ _____________________________________________ _____________________________________________ B. Disposition of Superintendent or Designee _____________________________________________ _____________________________________________ C. Position of Grievant and/or Association _____________________________________________ _____________________________________________ _____________________________________________ Step 3 A. Date Submitted to Arbitration _____________________________________________ _____________________________________________ B. Disposition & Award of Arbitrator _____________________________________________ _____________________________________________ Notes _____________________________________________ _____________________________________________ _____________________________________________ Serving You NJEA, as your professional organization, stands ready to help you and every other New Jersey school employee maintain and improve your status. Do you need advice, information, or NJEA at your side? Contact your local president who will put you in touch with direct assistance from your personal and ��������������������������������������������������������������������������������������������������������


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