Western Australian Consolidated Regulations

EMPLOYMENT DISPUTE RESOLUTION REGULATIONS 2008 - SCHEDULE 1

Form 1

[r. 7]

Employment Dispute Resolution Act 2008 s. 27 Western Australian Industrial Relations Commission Application No. ……... of 20….			Application to conduct dispute resolution process
Applicant	Name
	Contact person
	Mailing address
	Telephone
	Fax
	Email address
Application	I apply to have a dispute resolution process conducted by the Commission under the Employment Dispute Resolution Act 2008 section 27
Matter in dispute 1
Is the matter urgent? [Tick one box]	Yes         No
Parties to the matter in dispute 2
Party 1	Full name
	Contact person
	Mailing address
	Telephone
	Fax
	Email address
Party 2	Full name
	Contact person
	Mailing address
	Telephone
	Fax
	Email address
Party 3	Full name
	Contact person
	Mailing address
	Telephone
	Fax
	Email address
Name of relevant Commonwealth enterprise agreement				Number (if applicable)
Type of assistance sought from IR Commission
Signature of applicant				Date

Notes to Form 1 —

1.         Provide a brief description. Attach schedule if necessary.

2.         If more than 3 parties are involved attach a sheet identifying relevant details of each additional party.

        [Schedule 1 amended in Gazette 16 Mar 2012 p. 1251.]