Employee Disciplinary Action Appeal Form And Request For Board Of Review Form Page 2
Download a blank fillable Employee Disciplinary Action Appeal Form And Request For Board Of Review Form in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Employee Disciplinary Action Appeal Form And Request For Board Of Review Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3Employee’s Signature and Date: _______________________________________________________
Received by HR staff __________________________________ on this date ___________________
Eligible Issue for Review
Yes
No
Skip to 2
nd
Level Appeal
Yes
No
Received by Department Head __________________________________ on ______________________
Findings and decision of reviewing Department Head:
____________________________________________________________________________________
Department Head’s Signature
Title
Date
I accept this decision.
I want to appeal this decision to the 2
nd
Level, CEO.
I want to meet in person with the CEO.
Yes
No
IT IS YOUR RESPONSIBIILTY TO CONTACT HUMAN RESOURCES AND REQUEST TO CONTINUE YOUR
APPEAL. Appeals must be requested within 7 days of the Department Head’s decision.
Employee’s Signature and Date: _______________________________________________________
Received by HR staff __________________________________ on this date ___________________
2
Level Appeal (CEO Appeal)
ND
What is the nature of your claim, dispute or complaint?
See Above
( If your claim, dispute or complaint have changed as a result of the 1
st
Level Appeal, Please state the new claim,
dispute or complaint here .)
State your understanding of the discipline issued and any changes as determined by the 1
Level Appeal.
st
What specific solution or resolution are you requesting?
Do you want to meet with the CEO in person?
Yes
No
PINE CREEK INDIAN RESERVATION
1485 MNO-BMADZEWEN WAY • FULTON, MI 49052
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Pt-stm - Second Tier Pass-through Entity Owner Statement And Request For Waiver Of The Requirement To Withhold Or Pay Composite Tax
Financial
Form Cssd 04-0502 - Affidavit And Request For Nondisclosure Of Identiiyng Information - Departament Of Revenue Child Support Service Division
Legal
Form Pto/sb/09 - Certification And Request For Consideration Of An Information Disclosure Statement Filed After Payment Of The Issue Fee Under The Qpids Pilot Program
Legal
Sample Letter Of Withdrawal And Request For Transfer Of Records (for Families Filing A Private School Affidavit)
Letters
Related Categories
Parent category: Legal