Instruction:  to be submitted to the Employer / Manager / Training Provider upon completion.

FULL NAME AND ID NUMBER OF STUDENT PRESENTING THE CONCERN

______________________________________________________________________________________________

SALON NAME __________________________________________________________________________________

TRAINING PROVIDER ____________________________________________________________________________

WHOM IS THE GRIEVANCE LODGED AGAINST? (RESPONDENT)

SALON / EMPLOYER        YES / NO                        TRAINING PROVIDER        YES / NO

FULL NAME AND POSITION OF RESPONDENT

______________________________________________________________________________________________

STAGE 1: DATE OF RAISING CONCERN ______________________________________________________________

(To be resolved within three (3) working days or longer by mutual agreement)

NATURE OF GRIEVANCE

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

DESIRED RESOLUTION OR SETTLEMENT

______________________________________________________________________________________________

______________________________________________________________________________________________

MEETING TOOK PLACE AT _____________________________ ON THIS ___________________ DAY OF

______________________________ 20 ________

RESPONSE (to be completed by the respondent)

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

OUTCOME (to be completed by the chairperson)

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

SIGNATURE OF Respondent ________________________________ DATE _________________________________

I confirm that my concern has been resolved / not resolved to my satisfaction and I now wish / do not wish to lodge a formal grievance.

SIGNATURE of Student ________________________________ DATE _________________________________

SIGNATURE of Representative (if applicable) ___________________________ DATE _____________________

** Copy to be given to the Student and Respondent

STAGE 2: (If the grievance remains unresolved, refer the matter to the National Bargaining Council for Hairdressing, Cosmetology Beauty & Skincare Industry)

REASON FOR MY CONTINUED DISSATISFACTION: (to be completed by student)

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

DATE OF RAISING CONCERN WITH THE COUNCIL ____________________________________________________

COUNCIL NOTES AND COMMENTS

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

DOCUMENTATION RECEIVED BY THE COUNCIL

_____________________________________________________________________________________________

_____________________________________________________________________________________________

DATE OF MEDIATION ___________________________________________________________________________

OUTCOME OF MEDIATION

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

DESIGNATED AGENT SIGNATURE _______________________________ DATE _____________________________

I confirm that the grievance has been resolved / not resolved to my satisfaction.

SIGNATURE of Student ________________________________ DATE _________________________________

SIGNATURE of Representative (if applicable) ___________________________ DATE _____________________

** Copy to be given to the Student and Respondent

STAGE 3: If the grievance remains unresolved; the National Bargaining Council for Hairdressing, Cosmetology Beauty & Skincare Industry will assist the parties with the correct dispute resolution processes that need to be followed.

REASON FOR MY CONTINUED DISSATISFACTION: (to be completed by student)

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

DATE OF RAISING CONCERN WITH THE COUNCIL ____________________________________________________

COUNCIL NOTES AND COMMENTS

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

DOCUMENTATION RECEIVED BY THE COUNCIL

____________________________________________________________________________________________

____________________________________________________________________________________________

NATURE OF DISPUTE REFERRAL (Council forms to be used to refer the matter further)

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

DESIGNATED AGENT SIGNATURE ___________________________ DATE _____________________

I confirm that the grievance has been referred to the council for dispute resolution.

SIGNATURE of Student ________________________________ DATE _________________________________

SIGNATURE of Representative (if applicable) ___________________________ DATE _____________________

** Copy to be given to the Student and Respondent

There are no further stages to the grievance procedure.  The council will continue with dispute processes to refer the matter further.