Attachment II

                       STUDENT EMPLOYMENT GRIEVANCE FORM
 
 
Name:  ___________________________________________________
 
Social Security Number:  _________________________________
 
Date of Submission:  _____________________________________
 
Immediate Supervisor's Name:  ____________________________
 
Account Manager's Name:  _________________________________
 
Nature of Grievance:  (Please prepare a statement explaining your grievance.)
 
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List any witnesses to support your grievance:
 
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Note:  Submit this form in duplicate and in separate envelopes to your immediate supervisor and to the account manager for the account from which you are paid.  Keep a copy for your file.
 
 
 
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                                                 Student Signature