Please complete the following questionnaire to receive a FREE, CONFIDENTIAL preliminary evaluation from Employee Rights Attorney Frank Pray within 3 business days.

Your e-mail Address:

Your name:

Your personal and business website addresses:

Your home address including zip code:

Your telephone number, both cell and landline:

What Search Terms Did You Use to Locate Mr. Pray's Website?:

If you used an online legal directory, what was the name of the website providing the directory listing?:

If you entered search terms directly in Google, Yahoo, MSN or other search engine, which search engine did you use to find our website?:

Why did you choose to submit your employment law inquiry to Frank Pray?:

Name of Employer Causing Your Present Problems:

City and State Where You Worked:

Your Age:

What is the employer's industry and type of business?:

How Many Employees in this Company?:

When were You Hired?:

When were You Fired, Demoted, Transferred, etc.?:

Give the name(s) and title of the person(s) making the decision you believe to be wrong.:

Name and Title of Your Immediate Supervisor:

When Did This Person Become Your Supervisor?:

What were your annual earnings?:

Describe your daily standard job duties and activities for this employer:

Even if paid a salary, did you work more than 8 hours in a day without being paid overtime? If stating "Yes", also state your estimate of usual overtime hours per day:

Even if "salaried", were you denied two 10 minute rest break and/or a 30 minute meal break each working day? If "Yes", please provide details:

In taking this job, did you rely on false promises pre-hire that tricked you into taking the job? If so, state the false promies:

Summarize your last 3 annual performance evaluations, or if none, summarize whatever performance feedback you were provided, focusing on the last 12 months:

When did you first learn or suspect things were not going well for you at work?:

Describe the first events or problems that you believe mark the beginning of your difficulties with this employer?:

Before your job loss, were you warned either verbally or in writing that your performance could result in discipline or termination? If so, describe:

Were you fired? If so, state who informed you, and what you were told by that person:

Did you resign or quit your job? If so, why did you resign, and what did you state as the reason for resigning?:

Were you laid off or "downsized"? If so, state how many other people in the Company have been laid off in the last 6 months:

If laid-off, what information do you have that you should not have been one of those selected for lay-off?:

Discrimination may occur on the basis of AGE, RACE, SEX, MEDICAL CONDITION, DISABILITY, RELIGION, NATIONAL ORIGIN, SEXUAL ORIENTATION or other "PROTECTED CATEGORY". Do you believe your employer favored persons who were not in your "Protected Category"? If so, state the "Protected Category" and describe the "double standard" treatment:

Unlawful Retaliation may occur when you protest or refuse to participate in some employer sponsored action you believe to be illegal or highly unethcial. If you believe your employer retaliated against you, state what conduct your protested or resisted, who knew of your protest, and what action was taken against you in punishment for your protest:

Were you a Union Member or Government Worker? If so, provide details.:

Have you done any of the following since losing this job? Filed for Unemployment Compensation; Filed with with the EEOC or DFEH for Discrimination; Filed for Workers' Compensation; Filed for State Disability; applied for Short Term or Long Term Disability with the Company's Disability Plan Administrator? If "Yes" to any of these, state which apply, and provide date and status details:

What was the "official reason" given by the employer for your termination of employment?:

What do YOU believe to be the true reason(s)?:

Did someone replace you in your position after your termination or lay-off? If so, identify that person, and state as much as you know known about that person's age, race, national origin, health status, and general job qualifications, experience, and years with the company:

Have you found new employment? If so, state when you started work, the type of work your performing, and your current annual rate of pay:

If we accept a case for you, what do you hope to accomplish?:

What other useful or relevant information do you believe will assist in this evaluation?:

ALERT: BY USING THE "SUBMIT BUTTON" BELOW, YOU AGREE THAT YOU ASSUME ALL RESPONSIBILITY FOR DECISIONS RELATED TO YOUR POTENTIAL CASE AGAINST YOUR EMPLOYER. THERE IS NO ATTORNEY-CLIENT RELATION CREATED BY YOUR USE OF THIS INFORMATION FORM, OR BY OUR RESPONSE TO YOU BASED ON THE INFORMATION. ONLY A SIGNED RETAINER AGREEMENT WITH MR. PRAY WILL CREATE ANY OBLIGATION BY HIM FOR ACTIONS NEEDED TO BE TAKEN IN YOUR CASE. YOU ACKNOWLEDGE THAT THIS ONLINE PRELIMINARY EVALUATION IS INCOMPLETE, AND ANY RESPONSE DOES NOT CONSTITUTE LEGAL OPINION OR ADVICE UPON WHICH YOU MAY RELY.

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