Grievance Form

Representing Technical & Professional Workers in the Greater Boston Area

Grievant Name *

Job Title *

Grievant Personal Phone *

Employer *

Grievant Personal Email *

Company Reporting Location *

Grievant Service Date (NCS Date) *

Steward

First Level Supervisor *

Second Level Manager

First Level Supervisor Phone *

Second Level Manager Phone

First Level Supervisor Email *

Second Level Manager Email

Reason for Grievance *

Describe Grievance (Be as specific as possible including names, dates, location, etc.) *

Level as Steward

Today's Date *

IBEW Local 2222
159 Thomas Burgin Pkwy, 3rd Fl
Quincy, MA 02169

Phone 617-929-6000
Fax 617-929-6099
Info Tape 617-929-6060