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Employment questionnaire

Please complete and submit the questionnaire below for a free initial consultation on your employment law issue. Upon receipt, Philip Landau will assess your case and either email or call you to discuss this.


Name
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Address
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Email
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Telephone
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Mobile
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Date of birth
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Age
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Job title
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Employment commencement date
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Notice period
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Date of dismissal or resignation
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Last working day
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Please specify amount of any redundancy pay already received and date if applicable
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Reason for dismissal
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Employer's address
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Nature of business
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Contact name
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Position
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Contact's email address
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Workplace address
(if different from above)
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Employer's telephone
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Employer's fax
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Basic wage/salary per annum
(before tax)
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Please state basic take home per month
(after tax)
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Please specify any other benefits such as car allowance, medical cover etc.
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Please give the number of normal basic hours worked each week
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Bonuses
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if yes please specify
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Holiday outstanding
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How did you hear about us?
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If internet, which site?
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Brief history of events
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