Wrongful Dismissal Assessment Form
To submit your case to Alexander Atkinson Law Corporation, please fill out the form below. You will be contacted as soon as possible.
1. Description of your Employment:
Senior Executive Middle Management Upper Management Lower Management Foreman/Supervisor Professional Sales/Managers Engineer/technically skilled employee Labourer Clerical Other
2. Does your employer provide Employment Insurance, pension and other benefits?
Yes No
3. Who provides the tools of the job? example office equipment etc.
Your Employer Combination You
4. Your Date of Birth:
5. Date of Employment:
6. What was the reason given for your dismissal, if any:
7. Date of Dismissal:
8. Did you sign a written contract of employment:
9. Are you aware as to whether your employment will end on a specific date or is your contract of employment indefinite?
Fixed Term Indefinite
10. Describe circumstances of your dismissal:
11. Have you had any warnings in the past of in regards to a need to improve your job performance ?
12. Did your employer provide any notice upon dismissal ?
13. When was the notice given ?
14. Was notice given orally or in writing ?
Orally In Writing
Contact Information:
Name:
Company:
Address:
City:
Province:
Postal Code:
Phone No.
FAX:
E-mail:
How would you like to correspond:
Telephone Email Fax Mail
