Ramona Unified School District 720 Ninth Street, Ramona, CA 92065 (760) 787-2016

RUSD/RTA GRIEVANCE FORM A “Grievance” is an alleged violation, misapplication or misinterpretation of a provision of the Agreement, District Policy, or-practices that are related to the terms of the RUSD/RTA Agreement, and are grievable under the procedures set forth in Article 8. The purpose of this procedure is to secure, at the lowest possible Administrative level, equitable solutions to the problems which may from time to time arise affecting the welfare or working conditions of unit members. Both parties agree that these proceedings will be kept as informal and confidential as may be appropriate at any level of the procedure. Grievant ___________________________

Date Filed _____________________________

School ____________________________

Date of Informal Meeting _________________ (Level One) Grievance Number (HR Use Only) ____________

Assignment _________________________

Check one: Level Two ______ Level Three _______ Level Four ______ Level Five ______ (Note: Copies of prior completed forms must accompany grievance filed at each level following Level One) Statement of Grievance: (Reference Contract/Agreement/Policy/Practice)

Remedy Sought:

________________________________ Signature of Grievant Disposition/Response:

______________________________ Signature of District Administrator Note: If additional documents are needed, attach an additional sheet

____________________ Date