APPENDIX D
GRIEVANCE FORM
TENURED,
TENURE-TRACK BARGAINING UNIT
_____________________________________ __________________________________
NAME OF GRIEVANT DEPARTMENT
Remedy Sought: Articles in Question: Date of Occurrence as defined in Section 19.3.1: Description of Grievance:
Filing Date:_________________ Grievants
Signature:_____________________________
UT-AAUP
Representative:______________________________
If additional sheets need to be attached to the Grievance Form to provide additional space for description, remedies, explanations or responses, please make reference to such attachments in the appropriate place on this form.
Sent to:___________________________ for hearing
on:__________________________________________
Department Chairperson’s Response: ___________________________________________ ________________________________ Signature of Respondent Date
J
I (We) wish to appeal to the next step.
___________________________________ ________________
Signature of appellant Date
___________________________________ _________________
UT-AAUP Representative Date
Date Received by Office of Faculty Labor
Relations:________________________________________________
Sent to:___________________________ for hearing
on:_____________________________________________
Dean’s Response: ___________________________________ ______________________________ Dean’s
Signature Date
I (We) wish to appeal to the next step.
_________________________________
____________________
Signature of appellant Date
UT-AAUP
Representative:____________________________
Date:____________________________
Received by the Office of Faculty Labor
Relations:________________________________________________
Sent to:__________________________ for hearing on:_____________________________________________
Provost’s Response: ___________________________________________
________________________________ Provost’s Signature Date
UT-AAUP wishes to appeal to the ________________________________ ______________
Internal Arbitration Board (IAB)
UT-AAUP Representative
Date
Date Received by Office of Faculty Labor
Relations:_______________________________________________
Board Members named by President of University _________________________________
_________________________________
_________________________________
Board Members named by President of UT-AAUP _________________________________
_________________________________
_________________________________
Date(s) of Internal Arbitration Board
hearing:________________________________________
The Internal Arbitration Board Decision and Order shall
be attached following this page.