| South Connellsville | Date Filed:_______________ | ||||||||
| Volunteer Fire company | |||||||||
| Grievance Form | |||||||||
| Name:_________________________________________________ | |||||||||
| Address: _____________________________________________________________ | |||||||||
| Phone number: ___________________________________ | |||||||||
| INSTRUCTIONS: USE BLUE OR BLACK INK OR TYPE ONLY. Make {2} two copies. Turn one copy in to the | |||||||||
| Recording Secretary and one to the President. Keep one copy for yourself. | |||||||||
| Details of Grievance | If By-Laws violation state Article and section | ||||||||
| DO NOT WRITE BELOW THIS LINE For Committee Use Only______________________ | |||||||||
| Grievance Committee | |||||||||
| member #1: ______________________________________ | date received:__________________ | ||||||||
| member #2:_______________________________________ | date received:__________________ | ||||||||
| member #3: ______________________________________ | date received:__________________ | ||||||||
| meeting dates: _________________ | |||||||||
| interview date: _______________________ | |||||||||
| ______________________________ | |||||||||
| Committee Recommendation: | Date:_____________ | ||||||||
| ______________________________ | |||||||||
| President's signature: __________________________ | |||||||||
| Date: __________________________ | |||||||||