Working Women’s Legal Service Request Form

Please complete the details below to send us an email with your request for advice

* indicates required fields

Your First Name*

Your Surname*

Your Email*

Your Date of Birth*

Address Line 1*

Address Line 2

State NSWACTNTQLDSATASVICWA

suburb*

Postcode*

Your Phone*

Name of your employer*

Name of any individual person at your place of employment who you want to complain about*

Supporting Information

Describe what happened and what you are seeking advice about.*