Online Complaints

Name of Owner or Manager:

Business Name: *  

Business Type: *  

Employer's Address: *  

Employer's Telephone:

Approx. number of emloyees in business:

Job title: *  

Date you started employment (dd/mm/yyyy): *  

Date you finished employment (if no longer an employee):

How often are you paid: select.... Daily Weekly Monthly Fortnightly

What is your pay before Tax and National Insurance:£ *    

Hourly rate if known:£  

Hours worked in the period: *    

Your age range: select... 16 & 17 years old 18-21 years old 22 years and above *  

Are you undergoing, or have you undergone an apprenticeship or accredited training with this employer Yes
No *  

How are you paid: select... Cash Cheque Into Bank Account * 

Do your receive payslips: Yes
No *  

Your identity will not be revealed to your employer.

Name:

Address & postcode:

Telephone:

Email: *   

Date of birth (dd/mm/yyyy):

National insurance number:

Additional information: