AIRPORT QUALITY STANDARDS PROGRAM
COVERED EMPLOYEE COMPLAINT FORM
(All information is confidential)
Employee Name:
(Print or Type)
Address: _______________________________________________State: _________ Zip: __________ __
Home Phone: ________________________________________Other Phone: ______________________
Employer Name: _______________________________________________________________________
Your Job Title/Position: ______________________________________________________________ ___
How long have you worked for Employer? _______________________________________________ ___
Do you belong to a Union?
Yes_____ No______ If yes, which union/local #: ________________ ___
Please explain the details of your complaint in the space provided below (use extra sheets, if necessary).
Include the date when the violation(s) begin. If compensation and benefits are part of the complaint,
include how much money you believe you are owed.
Is the violation(s) still occurring? Yes______ No______
Signature: _________________________________________________ Date: ____________________
For Airport Use Only
Received by __________________________Date: _____________
Mail completed form to:
San Francisco International Airport
Investigated by________________________ Date: ____________
Attn: QSP Office
P.O. Box 8097
Date Resolved _______________________
San Francisco, CA 94128
Phone # (650) 821-1003
Case # __________________________________________
February 26, 2010