Individual Lawsuit Paid on an Hourly Basis Question Title * 1. Please enter your contact information. First Name * Last Name * Address * Address 2 City/Town * Province * Postal Code * Email Address * Phone Number * Question Title * 2. What is your Date of Birth? Date of Birth Date Question Title * 3. Are you able to pay all disbursements and an hourly fee of $300/hour plus a contingency fee of 10% at the end of the case? Yes No Question Title * 4. Are you able to provide a retainer of $10,000.00? Yes No Question Title * 5. Describe what happened to you and explain what Child Welfare did wrong that makes you want to sue them. Question Title * 6. When did the event that you want to sue for occur? Date of Birth Date Done