SENIORITY CHALLENGE FORM – USW LOCAL 2010

FILL OUT THIS FORM AND SUBMIT BY EMAIL TO hr.reporting@queensu.ca IF YOU DISAGREE WITH THE INFORMATION LISTED ON THE USW LOCAL 2010 SENIORITY LIST
Employee Name:	First: Click here to enter text.	Last: Click here to enter text.
Employee ID Number:	Click here to enter text.
Department:	Click here to enter text.
Campus Address:	Click here to enter text.
Campus Extension:	Click here to enter text.
Campus Email Address:	Click here to enter text.
Optional
Home Address:	Click here to enter text.	City: Click here to enter text.	Postal Code: Click here to enter text.
Home Phone:	Click here to enter text.
Cell Phone:	Click here to enter text.
The error on the Seniority List is: (Please check all that apply) ☐ Seniority Date is wrong Seniority Date stated on the List: Click here to enter date. ☐ My Name is not on the list ☐ Spelling error ☐ Information error ☐ Other
Please provide details if you checked “Other”: Click here to enter text.
The CORRECT information should be: Click here to enter text. If you are challenging your SENIORITY DATE, Please explain WHY you believe the posted seniority date is incorrect: Click here to enter text.
Work History: Date of first General Support Staff appointment with the University: Click here to enter date. List any employment with Queen’s University prior to the date listed above: Click here to enter text.