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Yes
No

An employee
An employer
A union official or representive

Yes
No

Union Representative Details


Applicant Personal Details



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



Yes
No

Details of the other Party


Yes
No


Nature of the Dispute


Please specify nature of dispute:




The applicable circular, bulletin or gazette
The post description.
The post numbers.
Yes
No




Relief Sought



Special Features / Additional Information


Briefly outline any special features that the ELRC needs to note
Add your Signature for Form E1

Informing the other Party


I confirm that a copy of this form has been sent to the other party/parties to the dispute and proof of this is attached to this form.

Commencement of Employment



Notice of Dismissal


How were you informed of your dismissal?
Yes
No

Disciplinary Hearing


Yes
No

Reasons for Dismissal


Please provide a reason:

Fairness/Unfairness of Dismissal




Do you think that the dismissal was procedurally unfair? (Were internal procedures followed?)
Yes
No


Do you feel the reason for the dismissal was substantively unfair?
Yes
No

Collective Agreement


ELRC Collective Agreement
PSCBC


Form E2


Affidavit


The dispute arose on after all attempts to negotiate or follow internal procedures of the Respondent failed.
The referral is days late
I did the following to pursue my rights after the dispute arose: *
I signed the referral form on
The reason/s that I referred the matter late is: *
I believe that I have good prospects of success because (explain with good reasons why you believe that you have a strong case): *
As the Applicant (employee), if condonation is not granted, I will be prejudiced because: *
I believe that the Respondent (employer party) will / will not be prejudiced if condonation is granted because: *
Any other relevant information: I humbly pray that the application for condonation be granted.
Add your Signaute for Form E2