Employment Law Case Review

	First Name*
	Last Name*
	E-mail Address*
	Daytime Phone*
	Evening Phone*
			Tell us about your situation: Which one of the following best describes your situation?* (Please choose one) Discrimination (race, age, gender, disability, pregnancy, etc.) Harassment Want review of separation paperwork Contract dispute Failure to pay wages/overtime Failure to provide rest or meal breaks Other
			Date of Occurrence*
			Employer Name*
			Employer Location*
			Briefly describe what your employer or supervisor has done wrong.*
			Have you been fired or demoted?*
			What do you think your employer will say about your situation - even if you think it is untrue*:
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