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I want to write an application for labor arbitration? How to write it, please?
Application for labor dispute arbitration

Applicant: # # # female, working in Shuerwude Packaging Co., Ltd., East Zone, Economic Development Zone, Luogang District, Guangzhou # # # # # ID number: 0000000000. ...

Legal representative: Zhou Baoan (# # # spouse), occupation, address # # # # ID number: 00000000000000 ... mobile phone 0000000. ...

Respondent: Shuerwude Packaging Co., Ltd., East Zone, Economic Development Zone, Luogang District, Guangzhou Address ........

Requested items:

I. Requesting an order that the applicant enter the medical treatment period from June 29th, 20 10 and enjoy the treatment during the medical treatment period.

2. Require the respondent to apply for medical insurance benefits in accordance with regulations (if the respondent pays medical insurance, it shall apply for reimbursement of medical expenses in accordance with regulations; if the respondent fails to pay medical insurance, it shall be reimbursed by the respondent in accordance with regulations).

Three. Require the respondent to pay the sick pay in full (social security only pays the personal part).

Four, request to entrust the occupational disease prevention and control institutions to identify the applicant's occupational hazards.

Facts and reasons:

On August 24, 2002, the applicant was sent by the labor service company to Shuerwude Packaging Co., Ltd., East Zone of Economic Development Zone, Luogang District, Guangzhou as a labor service worker.

On August 24th, 2005, the applicant became a regular employee.

On June 29th, 20 10, the applicant was in a trance at work and could not work normally. Accompanied by colleagues, I went to Guangzhou Fangcun Brain Hospital for treatment. I was hospitalized for three months, and my condition was slightly better. I was discharged from the hospital and went home for treatment. After a year of drug treatment after discharge, his condition basically improved and his mood was stable. The applicant has repeatedly asked to go back to work. From July 20 10 to August 20 1 10, the company paid 900 yuan every month, and after deducting social security 540 yuan, it paid 48,600 yuan for treatment, 8,750 yuan for the company and the rest for individuals.

On June 20 1 1 year, the applicant went to Guangzhou hospital for medical appraisal, and his condition was relieved. Suggest giving him a lighter job.

On July 5, 20 1 1 year, the applicant was informed to go to the company, only then did he know that he wanted to terminate the labor contract and asked to sign it before going to work. Otherwise, he asked to repay the company's arrears of 15250 yuan within a time limit and return it before July 30, 201/year, otherwise the court sued and urged the signature.

On July 8, 20 1 1, the applicant was forced to sign when he returned to the factory to pick up the goods, and the company borrowed money to deduct the compensation of 3500 yuan.

20111010/October10, the applicant relapsed again, and it was more serious. He beat everyone and went to Fangcun Brain Hospital for examination. The doctor asked for hospitalization, but he couldn't pay the deposit. He prescribed some medicine and went back to the rental house.

To this end, the applicant filed a labor dispute arbitration, requesting that the applicant enter the medical treatment period from 20 10 and enjoy the medical treatment period, and requesting that the respondent handle the medical insurance treatment according to the regulations (if the respondent pays the medical insurance, the respondent will reimburse the medical expenses according to the regulations; If the respondent fails to pay the medical insurance, the respondent shall reimburse the medical expenses according to the regulations) and ask the respondent to pay the sick pay in full (social insurance only pays the personal part). Hereby.

Legal Representative: MM DD YY.