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EMPLOYMENT QUESTIONNAIRE 3
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EMPLOYMENT QUESTIONNAIRE 3
Name
*
First
Last
Gender
*
Male
Female
Prefer not to say
Prefer to self-describe
How do you self-describe?
*
Address
E-mail address (where we may communicate freely with you)
*
Enter Email
Confirm Email
Telephone / Mobile (*optional)
Date of Birth
*
DD
MM
YYYY
Age
About your job
Job Title
Employment Commencement Date (please estimate if not known):
Day
Month
Year
Please tick here only if your commencement date is estimated
Yes, I have estimated my commencement date
Notice Period you are required to give to your employer
Notice Period your employer has to give to you (if different from the above)
Date of Termination of employment (if applicable)
This will be the date your salary ceased, whether it is the date of expiry of your notice period, or where you have been paid in lieu of notice.
Are you on sick leave? If so, how long has this been for?
Reason for dismissal or resignation (if applicable)
Has any redundancy or settlement sum already been offered? If so, how much?
Employer’s Name
*optional at this stage
Nature of your employer's business
Contact Name of HR Person/Line Manager (or both)
*optional at this stage
Email address of the above contact
*optional at this stage
Your employer's address
Your place of work (if different from above field)
Employer's work address
Employer’s Telephone
*optional at this stage
Please state gross basic wage or salary per annum (before deduction of tax)
Please state basic take home pay per month (after deduction of tax)
Please specify any other benefits such as car allowance, medical cover etc.
Please give the number of normal basic hours worked each week
Bonus
Yes/No
Discretionary/fixed
% of salary
Shares or deferred stock. Please give details where appropriate.
Holiday outstanding (how many days)
Full history of events. Please try to be as brief a possible: (the box will automatically expand if you need more space)
Have you already spoken to someone at Landau Law? If so, please state their name.
This will enable us to direct your questionnaire quicker to the correct person.
How did you hear about us? If Internet-which site?
Upload any relevant documents
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Select files
Accepted file types: pdf, docx, jpg, Max. file size: 50 MB, Max. files: 6.
Email a copy of this completed questionnaire to me
Yes
Only tick this box if you would like a copy to be sent to your email address which you have entered at the beginning of this form. Please do not tick this box if you believe this is email address is not confidential to you, or you have entered a work email address.
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