Common use of Statement of Appeal Clause in Contracts

Statement of Appeal. I accept the Administrative decision above; I refer the above decision to the next level Level 2 Level 3 Level 4 DATE OF RESPONSE Signature of Grievant Distribution of Form: Immediate Supervisor Superintendent Association Grievant Address City State Zip To: College Place School District #250 I, the undersigned, hereby authorize you as my employer to deduct from my salary and pay to the charitable organization representation fees equivalent in amount to the membership dues and assessments as certified by the Association. I agree that this authorization and assignment shall be irrevocable for the current school year and shall be automatically renewed each year thereafter unless written notice of revocation is given by me to the District and the College Place Education Association between August 1 and August 31 of any calendar year, and further agree that my revocation shall be effective on August 31 of the year in which notice of revocation is given. Date Signature

Statement of Appeal. I accept the Administrative decision above; I refer the above decision to the next level Level 2 Level 3 Level 4 ▇▇▇▇▇ ▇ ▇▇▇▇▇ ▇ ▇▇▇▇▇ ▇ DATE OF RESPONSE Signature of Grievant Distribution of Form: Immediate Supervisor Superintendent Association Grievant Address City State Zip To: College Place School District ▇▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇ #250 ▇▇▇ I, the undersigned, hereby authorize you as my employer to deduct from my salary and pay to the charitable organization representation fees equivalent in amount to the membership dues and assessments as certified by the Association. I agree that this authorization and assignment shall be irrevocable for the current school year and shall be automatically renewed each year thereafter unless written notice of revocation is given by me to the District and the College Place Education Association between August 1 and August 31 of any calendar year, and further agree that my revocation shall be effective on August 31 of the year in which notice of revocation is given. Date Signature