University of Wisconsin- Milwaukee
Academic Staff Hearing & Appeals Committee
Intake Form
The first step in filing an appeal, grievance and/or complaint is the mandatory submission of this
intake form. The form must be completed fully and will be returned without consideration if all
requested information is not provided.
Any questions concerning your appeal should be directed to the Chair of the Academic Staff Hearing &
Appeals Committee. http://www.uwm.edu/Dept/SecU/asgov/ashac/index.html
Academic Staff Member Name:
Date of Submission:
Title or Position:
College or Division:
Department:
Contact Information:
Work Address:
Work phone:
Home Address:
Home phone:
UWM Email:
Preferred email (if other than UWM account):
Please indicate the action that you are filing. If you are filing more than one action, you
must submit a separate intake form for each action.
http://www.uwm.edu/Dept/SecU/asgov/docs/polpro.html
___ Appeal of Non-Renewal
(UWM Ch. 106)
___ Appeal of Dismissal for Cause
(UWM Ch. 109)
___Appeal of Layoff
(UWM Ch. 110)
___ Filing a Complaint
(UWM Ch. 111)
___ Filing a Grievance
(UWM Ch. 112)
Please provide the name(s) and contact information for the person(s) against whom you are
filing an appeal, complaint or grievance.
Name:
Title or position:
Department:
College or Division:
Professional Relationship to you: (e.g. immediate supervisor)
UWM address:
UWM phone number:
UWM email:
University of Wisconsin- Milwaukee
Academic Staff Hearing & Appeals Committee
Intake Form
(Page 2)
PART A—Complete ONLY if you are filing an appeal of involuntary termination (Non-renewal,
Dismissal for Cause, or Layoff)
In considering issues of non-renewal, the Committee presumes that the decision of
the supervisor, executive committee, and or Dean is correct. The burden of proof is
with the appellant to prove otherwise based on the grounds established in UWS 3.08
and UWM Policies and Procedures 5.18 (1).
Appeals of non-renewal can be based upon one or more of the following factors, with material
prejudice to the individual. Please indicate the factor(s)that you believe apply to your situation.
___1. Termination was improperly based on conduct, expressions, or beliefs which are
constitutionally protected, or protected by the principles of academic freedom, or
___2. Termination was improperly based on factors proscribed by applicable state or federal
laws regarding fair employment practices, or
___3. Termination was based on improper consideration of qualifications for reappointment or
renewal. Improper consideration shall be deemed to have been given to the qualifications of an
academic staff member if material prejudice resulted because of any of the following:
___ 3a. The procedures required by rules of the Academic Staff were not followed, or
___ 3b. Available data bearing materially on the quality of performance were not
considered, or
___ 3c. Unfounded, arbitrary, or irrelevant assumptions of fact were made about work or
conduct
Based on the information provided above (1 – 3), please provide a clear and concise
narrative explaining why you are appealing your termination. Provide relevant and
detailed background information that recounts the history and chronology of events and
communication between the appellant and the decision-maker. This history should identify the
alleged improper actions on the part of the decision-maker, as well as any specific provisions
from UWS or UWM Policies and Procedures that the actions of the decision-maker violated. You
should submit any relevant documentation to support your appeal (e.g. Annual Performance
Reviews, Correspondence, Letters of Appointment, Official Position Description, reports of
relevant verbal communication etc.) Please provide a statement of the remedy you desire.
(Note: You should attach additional pages as necessary.)
Part B—Complete ONLY if you are filing a complaint or grievance.
Prior to consideration of a complaint and/or grievance, ASHAC must first be provided
evidence that the Academic Staff member has followed the proper protocol as
described in UWM Ch. 111.02 and 112.04 (Steps 1 through 3) which requires that
informal resolution be attempted prior to filing a formal complaint and/or grievance.
http://www.uwm.edu/Dept/SecU/asgov/docs/polpro.html
If you have not attempted informal resolution, you must do so prior to formally filing a complaint
and/or grievance. If you need clarification of this step in the process, please contact the ASHAC
Chairperson. ASHAC may assist you with this step by providing an impartial mediator if you so
desire.
If you have attempted informal resolution, please indicate which action you are filing:
___Complaint
(UWM Ch. 111)
___Grievance
(UWM Ch. 112)
Please describe the alleged improper behavior and/or actions prompting you to initiate this
process. Be sure to provide specific chronological instances of grievable actions, behaviors
and/or conduct and describe how this specifically resulted in harm to you. You may also submit
any relevant documentation to support your complaint/grievance. Please provide a statement of
the remedy you desire.
Please provide documentation and a chronological outline/narrative of your attempt(s) to
informally resolve the situation(s) showing that steps 1 –3 have been completed:
(You may attach additional pages as necessary.)