Register for Further Information - Starbucks Canada Class Action

You must fill in all fields marked with an asterisk (*) to Register.

Name *

First Last

Phone Number *

Extension (if applicable)

May we call you at the above phone number? *

Yes
No

Email Address

May we send you emails at the above address?

Yes
No

Home Address

Street Address Address Line 2 City Province Postal Code

Position with Starbucks

Position	Address of Starbucks Location worked at	Start date (DD/MM/YYYY)	End date (DD/MM/YYYY)

Comments

By ticking the confirm box below, I certify the following: *

(a) I am NOT a person who is or what a director or officer of Starbucks Coffee Canada, Inc. (“Starbucks”) or its affiliated or related organizations;

(b) I am NOT submitting this form on behalf of Starbucks or otherwise submitting this form as a representative or agent of Starbucks or its affiliated or related organizations;

(c) I am NOT a person who otherwise was not or is involved in the decision-making process for Starbucks or its affiliated or related organizations;

(d) I am NOT a person whose acts or omissions may expose or may have exposed Starbucks or its affiliated or related organizations to potential liability in relation to the claims made in the statement of claim (namely, claims relating to alleged misclassification and unpaid wages).

Yes, I confirm