Issue Reporting – Horizon Air

Issue Submission Form

Please fill this form out in its entirety using specifics and facts.

Name *

First

Last

Domicile *

5 Digit Emp # (not 7 digit Peoplesoft#) *

Date of Hire *

Phone # *

Email *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Upload Screenshot if Applicable.

Click or drag a file to this area to upload.

Describe Issue Fully – Issue and Facts Surrounding the Issue *

Digital Signature and Date

I hereby authorize the Association of Flight Attendants (AFA-CWA) and/or it’s representatives to act on my behalf in the disposition, discussion, and resolution of this grievance. Furthermore, as my representative, AFA-CWA is hereby granted full access to any and all confidential employee files, including but not limited to: Inflight Supervisor’s files and notes, confidential employee files, disciplinary notices or letters of reprimand, regardless of format (i.e. electronic or written) relevant to this complaint. Sign and Date:

Full Name *

First

Last

Date *

Phone