Mediation Services: Request for Mediation

Click here to read the Agreement to Mediate
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My Information

My name *
Title/Series Grade *
E-Mail *
Phone Number *
Fax Number
Organization *	Deputy Under Secretary NOAA National Environmental Satellite, Data and Information Service NOAA Marine and Aviation Operations NOAA National Marine Fisheries Service NOAA National Ocean Service NOAA National Weather Service NOAA Oceanic and Atmospheric Research NOAA Program Planning and Integration Office of the Under Secretary - NOAA Administrator Not otherwise listed
City *	State * Zip *

My Dispute is with:

Name *
Title/Series Grade
E-Mail *
Phone Number *
Fax Number
Organization *	Deputy Under Secretary NOAA National Environmental Satellite, Data and Information Service NOAA Marine and Aviation Operations NOAA National Marine Fisheries Service NOAA National Ocean Service NOAA National Weather Service NOAA Oceanic and Atmospheric Research NOAA Program Planning and Integration Office of the Under Secretary - NOAA Administrator Not otherwise listed
City *	State * Zip *

Briefly, my dispute is about:

(Complete the following section only if you needed to begin one of the
more formal processes in order to meet filing deadlines)

I have also filed:

an EEO Complaint (EEO Counselor's name, email address and telephone)



a grievance under NOAA procedures
a grievance under the (which union?) negotiated agreement

For the next month or two, I could schedule the mediation on the following dates:
(please give as many date choices as possible)