PMI Chapter Conflict Report

PMI Chapter Conflict Report

This form in intended to be used for Chapter Conflict disputes between two PMI chapter volunteers. This form is not intended to be used for issues with another individual or entity.

To provide a thorough investigation, we ask that you provide as much detail as possible, including names. Anonymous reports will automatically be disregarded. Our objective is to foster a respectful and positive environment, and we take all conflict reports seriously. You can be confident that the information you provide will be handled with the highest level of respect and confidentiality.

My Contact Information - Reports Filed Anonymously Will Be Rejected.

Requestor Name (Your Name)*

Your Chapter Role:

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Your PMI Member ID:*

Phone number:

E-mail address:*

My Dispute is with:

Disputant Name:*

Disputant Chapter Role:*

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Disputant's PMI Member ID (If known)

Disputant's Phone Number (If known):

Disputant's E-mail Address:*

Please provide detailed answers to the following questions

Provide all of the facts you know in response to each question.

1. Essential Facts*

Provide a statement of what you consider to be the essential facts involved in the chapter conflict or dispute.

2. Relationship with Disputant*

What is your positional relationship with the party(ies) with whom you have the dispute (Disputant)?

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3. Attempt to Resolve*

Have you tried to resolve the dispute directly with the Disputant(s)?

Yes

4. Have you raised this to the chapter board?*

Have you raised this formally to the chapter board?

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5. Were any issues resolved?*

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6. Other Persons Involved*

Are there any other persons involved in the dispute you believe should be contacted? If so, why?

7. What relief or result are you seeking?*

What relief or result are you seeking? What will be the benefit to the chapter, according to annual plan, bylaws, policies and procedures with the relief you are proposing?

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8. Mediation*

Do you request mediation?

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9. Additional Information (Limit to 200 words)*

Are you currently pursuing any other form of dispute resolution (e.g., litigation, arbitration)? Note that the PMI Chapter Conflict Mediation process will not be utilized when civil, criminal, or regulatory proceedings are ongoing.

10. File Upload

Please attach any documents involved in the issues in dispute.

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Statement and Certification

By entering my name and date below, I hereby certify that the information submitted in relation to this Dispute is true, accurate and complete. I affirm that all factual allegations and evidence presented in the report are genuine and obtained through lawful and ethical means. I understand the importance of honesty and integrity in resolving disputes and confirm that any misrepresentation, falsification, or omission could adversely affect the mediation process.

I also understand that the Disputant may receive a complete, non-redacted copy of this document, attachments, as well as other information submitted pertaining to this Dispute. I acknowledge and agree that PMI may contact individuals who may be witnesses. Further, I understand that some or all the information submitted regarding the mediation proceeding may be disclosed (in either redacted or nonredacted form) to PMI chapter members and others following the agreed end of this Chapter mediation management case.

Complaint Submitted:*

Case Number (Internal use only)

Chapter Name*

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Chapter Region

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Chapter

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Send me a copy of my responses

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