EXAMPLE OF FORM A

FORM A
(Rule 3)

IN THE INDUSTRIAL COURT

 Section 27 of the Act

APPLICATION TO BE REPRESENTED BY A LEGAL PRACTITIONER

 In the matter of Industrial Court Case No.........................of   2010

Between

Name of Employee

And
Company's Name.

PART 1--

 The President

Industrial Court

I/We.................................................................................................................................................................

hereby apply for permission to be represented at the proceedings before the Court in this case  by a legal practitioner.

My/Our reasons for the application are as follows   :........................................................

 Dated this ....................day of ..........................2010.

                                                                                                                  .........................................

                                                                                                                  Signature of Applicant

                                                                                                                 Address