Employee Associate Document

EMPLOYEE ASSOCIATE DOCUMENT

Personal Information

Position Information

Proposed Start Date:

Full-time Part-time Seasonal Contractor

Pay Frequency: Weekly Bi-weekly Monthly

Employment History

Dates Employed: From To

Dates Employed: From To

Education

Graduation Date:

Professional References

Legal Disclosures and Authorizations

At-Will Employment: Employment with the employer is at-will. Either the employer or the employee may terminate the employment relationship at any time, with or without cause and with or without notice, unless a separate written agreement signed by both parties expressly provides otherwise.

Equal Employment Opportunity: The employer is an equal opportunity employer. Employment decisions are made without regard to race, color, religion, national origin, sex, age, disability, genetic information, or any other characteristic protected by applicable law.

Background Checks & Verification: The employee acknowledges that employment is contingent upon satisfactory verification of employment history, references, education and any required background checks. The employee consents to such investigations and certifies that the information provided in this document is true and accurate under penalty of law.

I authorize the employer to conduct background checks, verify employment history, education, and professional references as necessary for the position.

Confidentiality and Intellectual Property: The employee agrees that all confidential information, trade secrets, proprietary data and work product created in the scope of employment are the exclusive property of the employer. The employee assigns to the employer all rights, title and interest in inventions, developments and works of authorship made during employment relating to the business of the employer.

I acknowledge and agree to the confidentiality and intellectual property provisions set forth above.

Drug and Alcohol Testing: Where permitted by law and as required for the position, the employee may be required to submit to drug and alcohol testing. Refusal to submit to required testing or a positive test result may result in withdrawal of the offer of employment or termination.

I consent to drug and alcohol testing as required by employer policy or position.

Handbook and Policies: The employee acknowledges receipt of, or access to, the employer's policies and handbook where applicable and agrees to comply with employer policies, procedures and lawful directives. Employer policies may be amended from time to time at the employer's discretion.

I acknowledge receipt of employer policies and handbook and agree to comply with such policies.

Governing Law and Severability: This document and any dispute arising out of it shall be governed by applicable law. If any provision is found invalid or unenforceable, the remaining provisions will remain in full force and effect.

Applicant Certification and Authorizations

I certify that the information contained in this document is true, complete and correct to the best of my knowledge. I understand that falsification, misrepresentation or omission of facts may result in refusal to hire or immediate termination of employment. I authorize prior employers, educational institutions and references to disclose information regarding my employment, performance and character to the employer.

I certify that all information provided is true and complete and I authorize the contacts and checks described above.

Disclosure — Convictions

Have you ever been convicted of a felony or misdemeanor other than a minor traffic offense? Yes No

Acknowledgment

By signing below, the employee acknowledges understanding and acceptance of the provisions contained in this Employee Associate Document and authorizes the employer to take the steps necessary to verify the information provided and to implement the terms described herein.

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