I hereby record my intention to register an appeal against the outcome/penalty following a disciplinary hearing held:

Nature of charge/s

1 _________________________________________________________________________
2 _________________________________________________________________________

Outcome: ____________________________________________________________________
Penalty: ______________________________________________________________________

Reason for the appeal:
Procedural: (Was the disciplinary process followed correctly)

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Substantial: (Was there facts which the chairperson did not consider or are there new facts that came to light)

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