Application for free legal service

PLEASE READ FIRST:

This application may take up to 45 minutes to complete. You will not be able to save your work.

To submit an application by email, fax or mail, download a copy of our application form by clicking here.

YOU WILL NOT RECEIVE ANY ADVICE AND [email protected] WILL NOT LOOK AT YOUR CASE UNTIL YOU HAVE BEEN APPROVED FOR FREE SERVICE.

THE APPROVAL PROCESS TAKES APPROXIMATELY 2 WEEKS.

IF YOU HAVE AN URGENT QUESTION OR MATTER, PLEASE TELEPHONE [email protected] AT 1-800-461-8953.

All questions marked with a star* must be answered. If these questions are unanswered your application will NOT be processed.

GENERAL PERSONAL INFORMATION


  1.   

  2. (leave blank if the same as your home)

  3. Day: Month: Year:

  4. NOTE: We need to know your current household income as of today. This means we need to know about all current earnings from every member of your household. For example, if you are currently unemployed but your spouse makes $25,000 a year, your income would be: 0 + 25,000 = $25,000.

  5. NOTE: The people you support financially may not necessarily live with you.
  6. YesNo

  7. FOR EXAMPLE:
    Legal Clinic
    Internet

    Internet search or link
    Legal Aid Clinic
    Legal Aid Ontario Office
    Employment Centre
    Court
    Lawyer
    Religious Group
    Union
    Community Centre
    Federal Member of Parliament
    Member of Provincial Parliament
    Government program
    Non-government organization
    Word of mouth
    Service Canada Office
    Ministry of Labour
    Ontario Works
YOUR COMPLAINT

Job details

Tell us about the job that you do or were doing that gave rise to this complaint:

  1. YesNo


    If no, what is or was your pay schedule?
    Monthly Bi-monthly Weekly At the end of the season
  2. Day: Month: Year:
  3. Day: Month: Year:
  4. YesNo

  5. For example: 123456 Ontario Ltd. may do business as Acme Store.
  6. Manual Labour/Construction
    Casino
    If yes, please also check the appropriate box below:
    Table Games dealer or supervisor
    Food Services
    Cleaning Services
    Security
    Other (please specify):
    Food Services/Restaurant
    Community Organization (like a centre, charity or a society)
    Migrant/Seasonal
    Telemarketing
    Commission/Sales (including retail)
    Other (please specify):

  7. Wrongful Dismissal (Termination without notice, termination without pay instead of notice)
    Constructive Dismissal (you felt forced to quit because of changes to your job or the nature of your job).
    Types of constructive dismissal include:
    Toxic Work Environment (due to treatment at work)
    Harassment
    Other (please specify):
    Laid-off
    Right-to-recall
    Human Rights Violation
    Discrimination on the basis of
    Disability
    Religion/Creed
    Race
    Sex
    Other (please specify):
    Failure to Accommodate Disability
    Human Rights Violation
    Health and Safety
    Wages/Deductions in wages
    Employment Standards Act
    Workplace Injury (WSIB)
    Other (please specify):
MITIGATION

Only complete this section if you are no longer working at the workplace you are complaining about

IMPORTANT: It is your legal obligation as a former employee to 'mitigate' your loss of income. When the word 'Mitigation' is used in a legal sense, it means lessening your loss once you have stopped working by looking for new work.

For this reason you must search for new employment. If you do not, you may get less money awarded to you by a judge or tribunal.

  1. YesNo
    If no, please go to question 3.
    If yes, please complete question 2 and skip question 3.

  2. Day: Month: Year:





    Monthly Bi-monthly Weekly At the end of the season
  3. Yes No

It is in your best legal interest to look for employment by scheduling and attending interviews, signing up with job placement agencies, attending resume or job search workshops, resource centres or job fairs. Doing this will show effort to mitigate your loss.

It is very important that you keep a written record of all your attempts to find new employment. Remember to include names, dates and times.

EMPLOYMENT INSURANCE BENEFITS


  1. YesNo
    a) IF YES: Have you been granted EI benefits?
    YesNo
    If you have been granted EI benefits, what was the date they were granted to you?
    Day: Month: Year:
    b) IF NO, [email protected] recommends that you apply for EI benefits
    c) ANSWER THIS QUESTION IF YOU HAVE BEEN DENIED EI:
    Are you appealing the denial? YesNo

SETTLEMENT OFFERS/SEVERANCE PACKAGES:

  1. Have you received an offer/severance package? Yes No
    IF YES: On what date did you receive the offer? Day: Month: Year:
  2. IF YES: Is there a deadline to sign the Settlement Offer/Severance Package and Releases? Yes No
    IF YES: What is the deadline for responding? Day: Month: Year:
  3. Have you responded to the offer? YesNo
  4. If there are any details that about the offer/package that were not mentioned in the first 3 questions of this section of the form, please tell us about them below:

COMPLAINTS UNDER THE EMPLOYMENT STANDARDS ACT

IMPORTANT: Under the law, certain complaints may be made to either court or the Ministry of Labour (under the Employment Standards Act ("ESA")). Once you pick court or the Ministry of Labour you cannot make a claim to the other. The awards available in court are sometimes much larger than those awarded under the ESA, so it is important that you talk to a lawyer before making an ESA claim. If you have recently made an ESA claim you may be able to withdraw it, but you should talk to a [email protected] lawyer first.

  1. Have you made a complaint with the Ministry of Labour under the
    Employment Standards Act ("ESA")?* YesNo
  2. IF YES: What type of complaint?
    Reprisal Parental Benefits Other (please specify):
  3. On what date was the complaint made or filed? Day: Month: Year:
TELL US ABOUT YOUR CASE

In your own words, tell us about your work complaint. Please include dates and names of all events and people involved (2000 words max). You can also email or fax your story to 1-877-326-9757 (Attention: [email protected]).

Complaint details are:
Below to follow by Email to follow by Fax

IMPORTANT INFORMATION

Thank you for filling out this form. You have taken the first step to accessing free legal assistance.

The information on this in-take form will be sent directly to [email protected] However, before we open a case file in your name, we require you to send us 3 additional forms and copies of the all documents relevant to your case.

You may send us the above documents by regular mail, courier, email or fax (see the bottom of this form for our contact information). A case file will not be opened in your name until we receive these documents. As soon as the paperwork is received, the team will review your file and get back to you within approximately 2 weeks.

Please download the three forms below. Remember that they can be sent by regular mail, courier, email or fax.

PLEASE DOWNLOAD, PRINT AND COMPLETE THE FOLLOWING FORMS.

THESE FORMS MUST BE SUBMITTED IN ORDER FOR YOUR APPLICATION FOR FREE LEGAL AID TO BE CONSIDERED.

TO HAVE COPIES MAILED OR FAXED TO YOU, CALL 1-800-461-8953 AND ASK FOR A [email protected] APPLICATION PACKAGE.

IF YOU DO NOT SEND US THESE FORMS WITHIN 2 WEEKS, WE WILL CONSIDER YOUR APPLICATION TO BE ABANDONED

Click on the following links to download:
Retainer
Income & Assets Declaration
Authorization and Direction
Mitigation chart – record of efforts to find new work and/or training

You must also include as many documents as possible from the list below:

  • Employment Contract
  • Termination Letter from your former employer
  • Record of Employment
  • Any written correspondence, including email, to or from your employer
  • Pay stub
  • Settlement Offer and Release/Severance Package and Release
  • Employee Performance Reports/Evaluations
  • Disciplinary Letters and/or Suspension Letters
  • WSIB documents
  • EI Docket/documents
  • Ontario Human Rights Commission Complaint and documents

All forms and documents must be sent to [email protected] within 2 weeks of filling out your online intake form. If this is not possible, please contact [email protected] directly. If we do not receive your information within two weeks, we will consider your application for service to be abandoned.

Please be advised that most of our communication will be by letter, however if you have any urgent questions or concerns, [email protected] can be reached directly at: 1-800-461-8953 extension 58.

Thank you for your cooperation. We look forward to hearing from you.

Toll free telephone: 1-800-461-8953
Toll free fax: 1-877-326-9757

Mailing Address:
[email protected]
Community Legal Clinic
Simcoe, Haliburton, Kawartha Lakes
71 Colborne Street, P.O. Box 275
Orillia, ON L3V 6J6