Submit a Case – Winning On Wednesday

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Submit a Case

WOW Thanks you for submitting a case

PLEASE FILL IN AS MUCH INFORMATION AS POSSIBLE, THEN CLICK “SUBMIT”

Your Information

Your First Name:*

Your Last Name:*

Your Company or Firm:*

Email:*

Cell Phone:*

Company Phone:

Street Address:

City:

State:

Zip code:

Other Party Information Other Party Information (2) Other Party Information (3) Other Party Information (4)

Other Party Information

Their Name:

Their Company or Firm:

Email:

Phone:

Street Address:

City:

State:

Zip code:

Other Party Information 2

Their Name:

Their Company or Firm:

Email:

Phone:

Street Address:

City:

State:

Zip code:

Other Party Information 3

Their Name:

Their Company or Firm:

Email:

Phone:

Street Address:

City:

State:

Zip code:

Other Party Information 4

Their Name:

Their Company or Firm:

Email:

Phone:

Street Address:

City:

State:

Zip code:

Case Information

(WOW will assume that you agree to hold a remote/virtual hearing unless you select “in-person” and enter a city where you would like to have the hearing held.)

Remote/Virtual Hearing Request In person requested in:

Case Name:

Your file Number:

Other party file numbers:

Mediation or Arbitration: MediationArbitration

Allow WOW to select neutral: YesNo

If no, please select 2 neutrals that you would like to use for your hearing and

Have all parties agreed to hold the hearing? YesNo

If you have an agreed date for the hearing enter it here

I give Winning on Wednesday permissions to send emails to the address listed Terms Of Services *Yes

To ensure that you receive emails in your inbox, you can add the email address to your contact list - info@winningonWednesday.com

Location:

Winning on Wednesday, LLC

3237 Long Beach Rd, Suite #107

Oceanside, NY 11572

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