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Please complete the following questionnaire to receive a FREE, CONFIDENTIAL preliminary email evaluation from Employee Rights Attorney Frank Pray. Call 949-251-1006 if you do not receive your evaluation within 5 business days.

Your e-mail Address:

Your name:

Your telephone number, both cell and landline:

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?:

Name of Employer Causing Your Present Problems:

City and State Where You Worked:

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.?:

What were your annual earnings?:

What was your Job Title? Describe your daily standard job duties and activities for this employer:

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 2 consecutive performance evaluations as "BELOW", "MEETS" or "EXCEEDS" Expectations.

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? (Identify the person and that person's job title who was the primary source of difficulty for you).

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.:

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 OR assume your duties 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 your new employment, 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. NOTE ALSO TIME LIMITS TO FILE A LAWSUIT OR ADMINISTRATIVE COMPLAINT APPLY. NO OPINION OR ADVICE IS GIVEN BY THIS FORM, OR BY ANY REPLY TO IT, WHAT THOSE LIMITS MAY BE IN YOUR PARTICULAR CASE. HOWEVER, GENERALLY, A 180 DAY LIMIT APPLIES TO E.E.O.C. FILINGS AND 1 YEAR TO CALIFORNIA F.E.H.A. (DISCRIMINATION) ADMINISTRATIVE FILINGS. OTHER CLAIMS HAVE OTHER DEADLINES.

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