Version 0109
EAST TENNESSEE STATE UNIVERSITY
FACULTY GRIEVANCE FORM
1. Name:
2. Position:
3. Department:
4. Name of immediate supervisor:
5. Date grievance initially discussed with supervisor:
6. Name of next-higher-level supervisor:
7. Date grievance initially discussed with next-higher-level supervisor:
8. Explanation of grievance. NOTE: You MUST include the specific ETSU policy,
Tennessee Board of Regents policy, and/or U.S. Constitutional right which you
believe has/have been violated. Identify by section number each section of the
policy or Constitution that you believe has been violated. If you prefer, you may
attach a detailed explanation.
9. Corrective action desired. If you prefer, you may attach a detailed explanation.
Version 0109
Please Note
You should review the relevant portions of the Faculty Handbook that apply to
Complaints and Grievances, Section 1.4.
You are advised to discuss your matter of concern with one of the Procedural
Consultants, who are trained to assist you in this process. The names and
contact information for the Procedural Consultants can be obtained from your
department office, dean’s office, Office of Human Resources, Office of Legal Affairs, and
the Faculty Senate website, http://www.etsu.edu/senate/.
Unless your matter of concern involves a violation of (1) ETSU policy, (2) TBR
policy, or (3) right(s) guaranteed in the United States Constitution, you should
consider filing a Complaint, rather than a Grievance. If you are unsure whether
your matter of concern is a “complaint” or a “grievance,discuss this with a Procedural
Consultant or review Section 1.4.4.1 of the Faculty Handbook.
THIS IS NOT THE PROPER FORM OR PROCESS FOR PURSUING A MATTER OF
CONCERN INVOLVING GENDER OR RACIAL DISCRIMINATION. See Section 1.4.3
of the Faculty Handbook for information about the proper avenues pursuing those
matters of concern or discuss this with a Procedural Consultant.
Please remember that you must
meet all established deadlines for filing this
Grievance. Failure to meet these deadlines can result in your grievance not
being heard or acted upon.
__________________________________ ____________________
Employee's Signature Date
If you have met with a Procedural Consultant, please provide his/her name:
As part of your meeting with this Procedural Consultant, you completed and signed an
Informed Consent statement and a Procedural Consultation Checklist. Please be aware
that a copy of these documents will be included among the official documents for your
Grievance.
click to sign
signature
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