Grievance Form PDF Details

A Grievance Form serves as a crucial tool in the reporting and resolution process of incidents within organizations, particularly those concerning policy violations or conflicts. This document must be submitted within a strict timeframe—specifically, within 30 calendar days of the incident—to be considered valid. It captures essential details about the incident, including the identity of the person lodging the grievance, the chapter(s) involved, and the specific date and approximate time when the incident occurred. The form categorizes grievances into types such as IFC, MCGC, NPHC, or PHA constitution issues, recruitment infractions, violations of alcohol policy, among others, allowing for a structured and focused approach to addressing the complaint. A comprehensive description of the incident, along with the identification of any members from each chapter who were present, is required for a thorough understanding and investigation of the situation. Furthermore, the form asks for the complainant's contact information, ensuring a line of communication throughout the process. A signature and date by the person submitting the form verify the accuracy and intent to pursue the grievance. The section designated for office use only, including the date received and a description of follow-up actions, underscores the procedural aspect of managing grievances, promoting accountability and transparency in the resolution process.

Form NameGrievance Form
Form Length1 pages
Fillable fields0
Avg. time to fill out15 sec
Other namescompleting, union grievance form template, NPHC, PHA

Form Preview Example


*must be turned in within 30 calendar days of incident*

Person completing the form_________________________________________________


Date of Incident____________________________ Approx. Time of Incident_________

Type of Grievance: IFC, MCGC, NPHC or PHA Constitution / Recruitment Infraction / Violation of Alcohol Policy / Other_________________________________________________


Description of Incident:

Members Present from each Chapter:

Contact Information

Phone Number_______________________ Email address________________________



Office Use Only:

Date Received____________

Description of Follow Up: