EGEA Grievance Intake Form
Please complete all sections of this form.  In addition, you may also want to directly contact the EGEA Grievance Director Maria Jackson at maria@elkgroveeducators.org for assistance.

If you are not sure whether your concern is a grievance, complaint, or another issue that you would like support with, you may refer to this link for more information. 
Sign in to Google to save your progress. Learn more
First and Last Name: *
School Site/District Department: *
Cell Phone Number *
Personal email address: *
CTA ID Number (this number can be found on your digital or printed CTA card as well as above your name on the mailing label of the California Educator Magazine). If you do not have this available, please type: IDK.  We can look this up. *
Grievance Information
A grievance is a violation of the Collective Bargaining Contract. You can reference the EGUSD/EGEA contract at the following website:  https://www.elkgroveeducators.org/contract.  

If you do not have a grievance, but have a complaint or need support regarding another issue, please contact Maria Jackson for assistance (maria@elkgroveeducators.org).
Which part of the collective bargaining agreement  has been violated?  Choose from the choice or list another using the "other" option. *
Please read Article 7: Grievance Procedure. 
Please briefly describe the violation: 
 *
What is a potential remedy to this situation that you would like to see? *
Have you or your EGEA site rep brought this concern to the attention of your administrator? *
What was the date on which you discussed this matter with your administrator?
MM
/
DD
/
YYYY
What was the outcome of the discussion with your administrator about this concern?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Elk Grove Education Association.

Does this form look suspicious? Report

Google Forms