Applicant Personal Details

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Alternate contact details of employee: (Neighbour/Friend/Colleague)

Do You Belong To a Trade Union ?
YesNo

Details of the other Party

Does this matter refer to Department of Higher Education and Training?
YesNo

Nature of the Dispute

Relief Sought

Special Features / Additional Information

Interpretation Services

Please be advised that ENGLISH is the standard language employed. You may therefore require interpretation services for another language.

Are you an educator?
YesNo

Special Features

Commencement of Employment

Notice of Dismissal

Disciplinary Hearing

Was there a disciplinary hearing before the dismissal?
YesNo

Reasons for Dismissal

Why were you dismissed ?

Fairness/Unfairness of Dismissal

Procedural Issues

Do you think that the dismissal was procedurally unfair? (Were internal procedures followed?)
YesNo

Substantive Issues

Do you feel the reason for the dismissal was substantively unfair? (Were internal procedures followed?)
YesNo

Referring for more than one person?

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