APPENDIX O

A printable version of this form can be found HERE.

SEA/SSD CONTRACT WAIVER REQUEST FORM

Building/Program: _______________________________________________________

Date of Request: ________________________________________________________

(Deadline: Must be into SEA & SSD Labor Relations by the 1st of the month.)

Contract: ____ Certificated: ____ SAEOP: ____ Paraprofessional: _____

Renewal: Yes: _____ No: ____

We are requesting to waive the following Articles and/or sections of the Collective Bargaining Agreement between the Seattle School SPS and SEA:

________________________________________________________________________________________________________________________________________________________________________________________________________________________

VOTING: All Certificated, Parapros, and SAEOPs must be involved in this voting process. You will need 2/3 majority of the SEA represented staff (members and non-members) to approve the waiver.

Total SEA Represented Employees in Building/Program:
	Certificated:
	SAEOP:
	Paraprofessional:

SEA Represented Employees Voting In Favor of Waiver:

SEA Represented Employees Voting Against Waiver:

Total number of SEA Represented Employees Voting:

Describe the intent of the proposed contract waiver:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What procedure did the staff use to vote on the waiver (secret ballot, show of hands, etc.?) ________________________________________________________________________

APPENDIX O

Continued

SEA/SSD CONTRACT WAIVER REQUEST FORM (continued)

What was the nature of the dissenting opinion(s), if any?

________________________________________________________________________________________________________________________________________________________________________________________________________________________

How many SEA Represented employees were directly involved in developing the contract waiver proposal? What was the nature of that involvement?

________________________________________________________________________________________________________________________________________________

Waiver Contract Signature (Must be a SEA member)

School #: __________________________Home#_______________________________

E-mail: ____________________________________

SEA Building Representative:
Signature:	E-Mail:
School #:	Home #

Principal or Designee Signature: ______________________________________________

Phone #:__________________________ E-Mail_______________________________

Recommendation: Yes _____ No ______

ACTION TAKEN

SEA: Date of Action: ________________ Approved: _______ Not Approved: _______

If not approved, the reason:

________________________________________________________________________________________________________________________________________________

SPS: Date of Action: ________________ Approved: _______ Not Approved: _______

If not approved, the reason:

________________________________________________________________________________________________________________________________________________

SEA President

SSD Signature