APPENDIX C
Grievance Form
Nashua Association of School Administrators and Supervisors OFFICIAL GRIEVANCE FORM
NAME OF EMPLOYEE DEPARTMENT.
WORK LOCATION IMMEDIATE SUPERVISOR
EMPLOYEE TITLE
STATEMENT OF GREIVANCE:
List applicable violation:
Adjustment required:
ee
1 authorize the Nashua Association of School Supervisors and Administrators as my representative to act
for me in the disposition of this grievance.
Date Signature of Employee
Signature of Union Representative Title
Date Presented to Management Representative
Signature Title
Disposition of Grievance: : ee
THIS STATEMENT OF GREIVANCE IS TO BE MADE OUT IN TRIPLICATE. ALL THREE ARE TO BE SIGNED BY
THE EMPLOYEE AND/OR THE NASHUA ASSOCIATION OF SCHOOL ADMINISTRATORS AND SUPERVISORS
REPRESENTATIVE HANDLING THE CASE.
ORGINAL TO
COPY
COPY: UNION GREIVANCE FILE
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