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LRFOA - GRIEVANCE COMMITTEE FORM
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* Indicates required question
Email
*
Your email
Grievance Presented By:
*
Your answer
Date of Grievance:
*
MM
/
DD
/
YYYY
Date Grievance Sent to Grievance Committee by Member:
*
MM
/
DD
/
YYYY
Date Grievance Committee Received Grievance from Member:
*
MM
/
DD
/
YYYY
Date Grievance Committee Brief sent to LRFOA Board Liaison:
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MM
/
DD
/
YYYY
Date Member Met with Grievance Committee:
*
MM
/
DD
/
YYYY
Advisements/Merits Considered By Grievance Committee:
*
Your answer
Grievance Committee Chairman Signature
*
Your answer
Date
*
MM
/
DD
/
YYYY
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