Grievance Procedure Form Initiation Step (Level I - Step 1A) Date* MM slash DD slash YYYY Name of Grievant(s);* Email* School(s); Position(s): Appropriate Supervisor (Authority to settle complaint):(See Article 5.3D) Statement of Complaint(s) (Grievance defined - Article 5.3A): Cite appropriate article, District policy, administrative regulations violated, or other alleged inequitable treatment, etc.Statement of Ready: State remedy desired by the grievant to adjust his/her complaint.Describe the background of the complaint and efforts made to resolve the dispute prior to filling written grievance; rationale for adjustment desired. (Article 5.4) Use additional pages if necessary.Signature of grievant(s); VEA PR&R Representative assisting in preparation of grievance: Date of Grievance (Article 5.4): MM slash DD slash YYYY Date grievance was submitted for written response: MM slash DD slash YYYY Last date written response is due grievant [five (5) full working days after date grievance was delivered to supervisor: MM slash DD slash YYYY Copies to: - Grievant - VEA - Superintendent/designee Date MM slash DD slash YYYY CAPTCHA