Employee Acknowledgement and Authorization

EMPLOYEE ACKNOWLEDGEMENT AND AUTHORIZATION

Personal Information

Position Information

Employment History (Most Recent Employers)

Employer 1 — Company Name

Employer 2 — Company Name

Education

Professional References

Reference 1

Reference 2

Reference 3

Acknowledgements and Authorizations

At-Will Employment: I understand that my employment with the employer is at-will, which means either the employer or I may terminate the employment relationship at any time, with or without cause or prior notice, unless a written agreement signed by an authorized representative of the employer provides otherwise.

I acknowledge and accept the at-will employment relationship.

Equal Employment Opportunity: The employer provides equal employment opportunity to all employees and applicants and prohibits unlawful harassment and discrimination.

I acknowledge receipt of the equal employment opportunity statement and agree to abide by company policies.

Confidentiality and Proprietary Information: I agree to maintain the confidentiality of the employer's proprietary information, trade secrets, customer lists, and other confidential data both during and after my employment. I further acknowledge that intellectual property created during the course of employment may be the exclusive property of the employer as permitted by applicable law.

I acknowledge the confidentiality and intellectual property obligations described above.

Drug and Alcohol Testing: Where permitted by law, I consent to drug and alcohol testing as a condition of hire and during employment in accordance with employer policy. I understand that a refusal to submit to testing, or a positive test in violation of policy, may result in discipline up to and including termination.

I consent to pre-employment and reasonable-suspicion testing as described above.

Background, Reference and Credential Checks: I authorize the employer and its agents to verify my employment history, education, professional licenses, and references and to obtain consumer reports, criminal background checks, and other investigative reports as permitted by law. I authorize all persons, schools, companies, and law enforcement agencies to release such information.

I authorize the employer to obtain background, reference and credential checks and release the employer from liability for obtaining this information.

Payroll Deductions and Reimbursements: I authorize deductions from my pay for lawful items including authorized benefit contributions, taxes, wage overpayments, property loss or damage, and other deductions authorized in writing consistent with applicable law.

I authorize lawful payroll deductions as described above.

Data Privacy: I consent to the collection, use, storage, and processing of my personal information for employment purposes, including but not limited to payroll, benefits, background checks, and compliance with legal obligations.

I consent to the collection and processing of my personal data for employment purposes.

Applicant Certification and Authorization

I certify that all information I have provided to the employer is true, complete, and correct to the best of my knowledge. I understand that any false statements, misrepresentations, or material omissions may be grounds for refusal of employment or, if employed, disciplinary action up to and including termination. I authorize the employer to verify the accuracy of the information provided and to obtain additional information regarding my background, as described above.

I certify that the information provided on this form is true and complete and authorize the verifications set forth above.

Sign Now