Items marked with a red diamond ♦ are required fields.

Appeals Process & Type

	♦ Acknowledgement
Appeals Process	I hereby acknowledge I have completed the following steps prior to submitting this appeal form: I have sought an acceptable administrative resolution in writing within 7 calendar days of the incident through one administrative level above the level of the supervisor who took the original employment action. A satisfactory resolution was not achieved and therefore I am filing this appeal within 7 calendar days from that written notification.
	Please Note: Documented proof of the denial must be attached to this form in the appropriate section.

	♦ Type
Type	Staff Suspension Staff Demotion Staff Termination Faculty Termination Faculty Status and Grievance Committee (FSGC)* (Select One)

	♦ Sub-Level
	(Select One)

	Please Note: A General Faculty member may submit a written request for an informal hearing directly to the Chair of the Faculty Status and Grievance Committee (FSGC).

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