General Issue SubmissionNot sure exactly where your report goes? Please fill this form out in its entirety using specifics and facts.Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.LayoutName *FirstLastDomicile *ANCBOIGEGMFRPAEPDXSEALayoutDate of Hire *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Phone # *5 Digit Emp # (not 7 digit Peoplesoft#) *Email *AddressAddress Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeUpload 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 DateI 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 *FirstLastDate *EmailSubmit