Grievance Worksheet

The results of this form will be sent to the MEC Grievance Committee who will contact you for more information. If the issue is urgent, please contact your Local AFA officers.


1) First Name
2) Last Name
3) Email Address:
4) Employee Number
5) Where Are You Based?
6) Your Address:
7) City
8) State
9) ZIP
10) Daytime Phone:
11) Cell Phone:
12) Best time to call:

Morning Noon Evening

13) Date of Incident: DD/MMM/YY
14) Employee's statement: Describe in detail the action giving rise to the complaint. Specify names, dates, places and site of violation, witnesses, etc...
15) Reference Contract Section that you believe supports your claim:
16) Did you have a discussion with a member of the Inflight Staff/Crew Scheduling

Yes No

17) If Crew Scheduling - Whom?
Crew Scheduler
Duty Manager
Crew Coordinator
18) Did you ask for Review of Crew Orders ?

Yes No



Please enter the word you see in the image below to submit this form: