Appendix P

DATE: ______________

I, _____________________ _________________________ have been

(print name) (signature)

advised that Non-Academic Staff Association (NASA) representation is available to assist me with this meeting, however, I have chosen to deny such representation in favour of proceeding on my own accord. I am aware of the time limits under the Board/NASA collective agreement that must be followed to file a grievance.

___________________________ _________________

Witness Date

cc: Copy to Employee
Copy to Employee Relations