Fillable APPEAL REQUEST A COPY OF THE DISCIPLINARY FINDINGS (City of Dayton)

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APPEAL REQUEST A COPY OF THE DISCIPLINARY FINDINGS (City of Dayton)

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FOR CIVIL SERVICE USE ONLY
APPEAL REQUEST
CIVIL SERVICE BOARD
A COPY OF THE DISCIPLINARY FINDINGS MUST BE ATTACHED
First Name
M.I.
My current residence:
Street Apartment Number
City State
Zip Code
Position Title
Department
Division
I hereby appeal the following action:
Position
Position
I will be represented by:
Signature
CSB092906
Case No.:
DATE:
Demotion
Suspension
Dismissal
Effective Date:
Effective Date:
Effective Date:
Union Rep. MyselfAttorney
Dayton Public Schools Employee
City of Dayton Employee
FROM:
Home Phone:
Work Phone:
Number of Days:
From:
To:
Name:
Address:
Phone:
Last Name
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APPEAL REQUEST A COPY OF THE DISCIPLINARY FINDINGS (City of Dayton)

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Completed 3 August 2020

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