Wrongful Dismissal Questionnaire - Shell Lawyers

	The information you provide below is some of the questions our lawyers may wish to ask you when you meet with them. All of the information will be kept completely confidential and is subject to our firm's Privacy Policy.
	* Required Fields
* Name:


* Email Address:


1. When were you dismissed from your employment?


2. How long were you employed by your former employer? (In years and months)


3. Which term below best describes how you applied to your former employer?


4. Which term below best describes your role at your former employer?


5. What reason, if any, did your former employer give to you as the cause of your dismissal?
	Internal Reorganization/Redundancy Inadequate Performance Cost Cutting Health/Age Other

6. Prior to your dismissal were you receiving any disablility benefits or compensation for a workplace injury?
	Yes No

7. Are you a member of a union?
	Yes No

8. Have you found new employment?
	Yes No

9. If you have found new employment, which term below best describes your new employment?


10. How did you learn about Shell Lawyers?
	Website Referred by another Lawyer From a Friend Other