Please fill in the times that it would be IMPOSSIBLE for you to participate in a grievance hearing.

NAME:

Telephone: E-Mail:

Preferred communication - Telephone E-Mail

April 6 AM_________________________ PM_____________________________

April 7 AM_________________________ PM_____________________________

April 8 AM_________________________ PM_____________________________

April 9 AM_________________________ PM_____________________________

April 13 AM________________________ PM_____________________________

April 14 AM________________________ PM_____________________________

April 15 AM________________________ PM_____________________________

April 16 AM________________________ PM_____________________________

April 19 AM________________________ PM_____________________________

April 20 AM________________________ PM_____________________________

April 21 AM________________________ PM_____________________________

April 22 AM________________________ PM_____________________________

Return to: ______ Chair, GGB, 104 Justin by March 5, 2004