Name of Aggrieved Employee: __________________________________________________________________________
Classification: _ ________________________ Department: _ _______________________________________________
Current Address: ___________________________________________________________________________________
BOWIE STATE UNIVERSITY
University System of Maryland
Employee
What is your complaint?
____________________________________________________________________________________________
What do you think should be done?
____________________________________________________________________________________________
Who, if anyone, do you name as your representative?: ____________________________________________________
Signature: ______________________________________________________ Date: _______________________
Department Head
STEP ONE
Date form grievance was received by Department Head or designee: ___________________________________________
Deposition
____________________________________________________________________________________________
Signature: ______________________________________________________ Date: _______________________
Employee
I wish to appeal the results of Step One of the grievance procedure.
Signature: ______________________________________________________ Date: _______________________
Form for Formal
Request, Problem,
Complaint, or Grievance