Usta League Grievance Form (Page 3 of 4) in pdf

Updated 1/27/14

Appeal – Page 3 of 4

USTA LEAGUE GRIEVANCE APPEAL

Any party to the Grievance who is considering an appeal of a decision of the Grievance Committee should familiarize

themselves with Section 3.04 of the USTA League Regulations.

APPEAL FILED BY:

Name/Title: ___________________________________________________ Date: _______________ Time: _______________

League Division: ____________________________ NTRP Level: ________ Team Name: _____________________________

District/Area and Section of Individual Appealing: ________________________________________________________________

Phone number (local contact and/or cell): ___________________________ E-mail Address: _____________________________

Signature: __________________________________________

APPEALING THE GRIEVANCE COMMITTEE DECISION OF:

Name/Title: ___________________________________ Team Name: ___________________________ NTRP Level: ________

Name of Local League: _______________________ District/Area: _______________________ Section: ___________________

Location or Site of Match or Incident prompting Grievance: __________________________________________________________

Date and Time of Match or Incident prompting Grievance: ___________________________________________________________

FACTS AND ARGUMENTS IN SUPPORT OF APPEAL: (Information provided in this appeal should be factual in nature.

Please provide as much specific detail and supporting background as possible.)

___________________________________________________________________________________________________________

OFFICIAL USE:

Appeal Form received by Grievance Appeal Committee Chair:

Name: _____________________________

Date: ________________________ Time: _________________

Appeal Form received by Grievance Committee Chair:

Name: _____________________________

Date: ________________________ Time: _________________

Appeal Form sent to other party(ies):

Name: _____________________________

Date: ________________________

Time: _________________

Usta League Grievance Form Page 3