Reference Library - Our Tesco

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GRIEVANCE FORM Let us know the reasons why you wish to raise a formal grievance by sending this form to your manager, managers’ manager or People Manager. Refer to the grievance policy on OurTesco for more information. Your surname: _________________________________ Your first name: ________________________________ Store Name and Number: ________________________________ Reasons for grievance: General; Health & Safety; Terms and Conditions; or Discrimination & harassment. Please detail below the reason(s) for your grievance (continue on a separate sheet if necessary)

Your Signature:

Date: Internal, December 2015

Stage One Meeting Attended by: Following the meeting: (Please )  I agree to withdraw the grievance  I accept the grievance has been resolved  I accept a final decision was given  I wish to refer the grievance to Stage Two for the following reasons:

Your Signature:

Date:

Stage Two Meeting Attended by: Following the meeting: (Please )  I agree to withdraw the grievance  I accept the grievance has been resolved  I accept a final decision was given for the following reasons:

Your Signature:

Date:

Internal, December 2015