Elgin Community College Faculty Association
1700 Spartan Drive l Elgin, IL 60123 l FAX (847) 622-3060
Grievance # 2008-2009-x
Grievant: 

Date of interview: 

Interviewers present:

Signed/Date:
1.
2. 
3. 

Briefly identify or title grievance:
(WHEN) Date of grievance: on or about 
(WHERE) Location of the grievance:
(WHO) Identify parties involved: 
(WHO) Identify witnesses:

Contacted by committee/date?
	1.	_____________________
	2.	_____________________
	3.	_____________________
	4.	_____________________
	5.	_____________________
	6.	_____________________
	7.	_____________________
	8.	_____________________
	9.	_____________________

(WHAT) Describe what happened in the incident:
Interviewer: List below any questions to be asked: