MTA Solicitors : Employee Enquiry Form

Title

First Name *

Surname *

Address *

Town

County

Post Code *

Your Date Of Birth *

Contact Phone Number *

Mobile Phone Number

eMail Address

What was your Position/Job Title? *

What is the name of your Employer?

When did your Employment Start? *

Was this the last date you worked?

Yes No

If no, Confirm the last date

If you are complaining about being discriminated against, please confirm the date of the alleged discrimination

Please give a brief description of the alleged discrimination you have suffered

What was the employer's reason for dismissing you?

What do you consider were the reasons for dismissing you?

Have you appealed?

Yes No

When did you appeal

Have you lodged any grievance with your employer?

Yes No

When did you do this?

What was your notice period?

Have you received you full notice period?

Yes No

Have you been paid for any notice instead of having to work?

Yes No

What was your salary?

Has the employer offered any ex-gratia payments?

Yes No

What would you be looking for from the Tribunal?

Have you made a claim at the Employment Tribunal?

Yes No

Please provide details of the claim you have made and wether you have been provided with any time limits by the Tribunal