UNISON representative would assist you, and you can identify specific needs (for example palantype, large print, or mobility needs for meetings) please indicate. 4. Section 5 If you identify with UNISON’s self-organisation and have a colleague who you would like to accompany you to meetings with your UNISON representative or with the employer, please give details. 5. Section 6 must be completed. If an Employment Tribunal claim needs to be made you are required to provide this information on the form. 6. Sections 7 - 8 should only be completed if they are relevant to your case. 7. Section 12 complete this section if you have received representation outside of UNISON or you have triggered the ACAS Concilation procedure. 8. Section 13 Fee Advance and Early Conciliation Agreement Please read the notes A Conditions for providing assistance before signing this section. You should only sign this section if you agree to all the terms in relation to the fee advance and early conciliation. You should hand the original to your representative and ask that you be given a copy. You should keep this in a safe place for future reference. It is a binding agreement between you and UNISON. 9. Section 14 Declarations Please sign if you agree to all the terms in this agreement between you and UNISON. 10. give it to your UNISON workplace When you have completed the form representative. If there is no UNISON representative at your workplace, send the form to your branch secretary. UNISONdirect will give you the name and address of your branch secretary phone 0800 0 857 857. – 11. You Please note the Conditions for providing assistance at A above. should only sign the declaration in section 14 if you agree to all of these conditions. 12. Please make a copy of the CASE form for your records or ask your workplace representative to make a copy for you.
UNISON representative would assist you, and you can identify specific needs (for example palantype, large print, or mobility needs for meetings) please indicate. 4. Section 5 If you identify with UNISON’s self-organisation and have a colleague who you would like to accompany you to meetings with your UNISON representative or with the employer, please give details. 5. Section 6 must be completed. If an Employment Tribunal claim needs to be made you are required to provide this information on the form. 6. Sections 7 - 8 should only be completed if they are relevant to your case. 7. Section 12 complete this section if you have received representation outside of UNISON or you have triggered the ACAS Concilation procedure. 8. Section 13 Fee Advance and Early Conciliation Agreement Please read the notes A Conditions for providing assistance before signing this section. You should only sign this section if you agree to all the terms in relation to the fee advance and early conciliation. You should hand the original to your representative and ask that you be given a copy. You should keep this in a safe place for future reference. It is a binding agreement between you and UNISON. 9. Section 14 Declarations Please sign if you agree to all the terms in this agreement between you and UNISON. 10. When you have completed the form give it to your UNISON workplace representative. If there is no UNISON representative at your workplace, send the form to your branch secretary. UNISONdirect will give you the name and address of your branch secretary – phone 0800 0 857 857. 11. Please note the Conditions for providing assistance at A above. You should only sign the declaration in section 14 if you agree to all of these conditions. 12. Please make a copy of the CASE form for your records or ask your workplace representative to make a copy for you.
Toweb22358_CaseFormApril14LargePrint2.docx