Intake Form

Are you a Registered Member of the AJC? If not, you must complete and submit a membership form prior to receiving assistance from the AJC.

Respect – Like our members, AJC staff must work in a safe and healthy environment. Verbal abuse and aggressive or violent behaviour towards staff will not be tolerated.

Is your inquiry an urgent matter that may need a rapid response from our Representation Team? *

Yes

Urgent matters may include, for example, an imminent upcoming grievance deadline, a disciplinary meeting with the employer, termination on probation, or pay issues requiring immediate assistance due to hardship. Please note that if we determine that your inquiry is not of an urgent nature, you will receive a response within our normal timeframe.

Please note that completing this intake form does not represent filing a grievance. Information on the process to file a grievance can be found here.
Factors considered by the AJC in filing a grievance are set out in the AJC Representation Services Policy.
The deadline to file a grievance is 25 workings days from the date of the breach or the date on which you first became aware of a breach. It is your responsibility to track and meet this deadline, which excludes weekends and designated holidays.

Urgent Matter

Indicate reasons(s) for needing a rapid response including any details, dates and deadlines.

Please note that completing this intake form does not represent filing a grievance.
Information on the process to file a grievance can be found here.
Factors considered by the AJC in filing a grievance are set out in the AJC Representation Services Policy.
The deadline to file a grievance is 25 workings days from the date of the breach or the date on which you first became aware of a breach. It is your responsibility to track and meet this deadline, which excludes weekends and designated holidays.

Response required by

References

Have you consulted our FAQs?

Yes

Have you contacted a Governing Council Representative?

Yes

Who did you contact?

Section 1 - Personal Information

Name of Member *

Pronouns

Preferred language of choice

Department/Agency *

Place of Work *

Classification *

Position Title

Position Number

(if known)

Work Address

Work Phone

Home Address *

Mobile Phone *

Personal Email Address *

Section 2 - Intake Summary

Date of occurrence giving rise to your request

(if applicable)

Name(s) of Management Involved:

Details *

Section 3 - Actions

Actions Taken to Date

Remedial Actions Sought

Component: Form Block