EMPLOYEE SIGNATURES I/We requested these concerns be forwarded to the Employer-Union Committee. Signature: Phone No: Signature: Phone No: Signature: Phone No: Signature: Phone No: Date Submitted: Click here to enter a date. Time: SECTION 7:
Employee Signature Employee ID: Telephone No: Employee Address: Work Location:
SIGNATURE AND DATE The Parties hereby agree to the terms and conditions set forth in this Agreement and such is demonstrated throughout by their signatures below:
Signature of witness Address of Witness
AGREEMENT SIGNATURES By signing below, both parties agree to the terms and conditions of this Agreement. Please acknowledge acceptance of this document and terms by returning a signed copy within seven (7) days of issuing. If a signed copy is not returned within seven (7) days and you are attending service, Fighting Chance will deem this to be acceptance of the document. If signєd by Xxx XxxXxxxxxxX: Signature of Participant: Date: If signєd by ™єprєsєnĒaĒivє: I confirm that this Agreement has been explained to the individual receiving the services and that they agree to the terms. I further confirm that I have authority to sign on their behalf. Signature of Representative: Date: SignaĒurє on bєhalf of FighĒing Chancє: Signature of Representative: Date: Name: Appendix 1 NDIS Claiming Preferences Fighting Chance supports NDIS participants who are NDIA-Managed, Self-Managed or Plan Managed. To invoice and bill you correctly, it is important you keep us updated with your plan management preferences, and let us know ongoing if your status changes. Please note, funding for Positive Behavior Support is billed from the Capacity Building Relationships category, which is often NDIA Managed. Please advise if your CB relationship funding is managed di erently. For the purposes of services delivered by Fighting Chance, your NDIS plan is: (please tick) ☐ NDIA-MANAGED You understand that Fighting Chance will claim directly through the NDIA portal if your funding for Fighting Chance is NDIA-managed, so you will not receive any direct request for payment from us. To ensure that you do not get a text from the NDIA to approve each claim weekly, endorse Fighting Chance as a ‘My Provider’ for automatic payment processing. Instructions can be found at xxxxxxxxxxxxx.xxx.xx/xxxx/ or you can contact the Fighting Chance My Provider Endorsement Helpdesk on (00) 0000 0000 or xxxxxxxxxxxxxxx@xxxxxxxxxxxxx.xxx.xx A statement of account is available on request directly from your clinician. ☐ SELF-MANAGED ☐ I am self-managed and would like to be invoiced for services to the email below. Please email invoices to: Please see Appendix 3 for Self-Management Payment Options. ☐ PLAN-MANAGED Please send invoices to my plan manager: Plan management organisation Contact Name Email Address Phone number ☐ OTHER FUNDING (eg. self-funded) Please email invoices to: Appendix 2 Self-Managed Payment Options Participants who are self-managed have a number of payment options with Fighting Chance: ☐ DIRECT DEPOSIT (preferred option) Payment of Fighting Chance invoices can be made by Electronic Funds Transfer (EFT) through your bank. Fighting Chance’s bank account details are as follows: Bank: Commonwealth Bank of Australia Account Name: Fighting Chance Australia Ltd BSB: 062-438 Account Number: 00000000 To ensure all payments are correctly allocated to your account, please include the full invoice number in the reference field. ☐ CREDIT CARD Payments can be made by credit card by clicking the ‘pay by credit card’ link included on the invoice. Please note that a service fee for this option will be imposed. ☐ PAYPAL Payment of your invoices can also be made via our PayPal account. To make payment via PayPal, please access the following link: xxxxx://xxxxxx.xx/FightingChanceAus?locale.x=en_AU
Employee Who Acts as Representative Where an employee wishes to represent at a meeting with the Employer, an employee who has presented a grievance, the Employer will, where operational requirements permit, grant leave with pay to the representative when the meeting is held in the headquarters area of such employee and leave without pay when the meeting is held outside the headquarters area of such employee.
DISCIPLINE, DISMISSAL AND RESIGNATION 23.01 Unsatisfactory conduct by an Employee which is considered by the Employer to be serious enough to be entered on the Employee’s record but not serious enough to warrant suspension or dismissal shall result in a written warning to the Employee and a copy to the Union within ten (10) days of the date the Employer first became aware of, or reasonably should have become aware of the occurrence of the act. A written warning that is grieved and determined to be unjustified shall be removed from the Employee’s record.
Employee Safety A. Any employee who is injured or who is involved in an accident during the course of his/her employment, no matter how slight the injury, shall file an accident report with the designated supervisor, as soon as possible after the injury and prior to the conclusion of the employee's work day, whenever possible. While the initial report may be given orally, it must be followed up within 48 hours with a written report on the First Report of Injury form which shall be submitted to the appropriate administrator/supervisor who shall then submit it to the appropriate Human Resources Department.
