Employee Confirmation of Instruction

EMPLOYEE CONFIRMATION OF INSTRUCTION

Personal Information

Position Information

Employment type: Full-time Part-time Temporary Contractor

Instruction & Training Acknowledgment

I acknowledge that I have received the following instruction, training, and materials as indicated below and understand my obligation to comply with company procedures, safety rules, and confidentiality requirements.

Mandatory Instruction Provided Safety and Emergency Procedures — Date Completed: Harassment Prevention — Date Completed: Confidentiality & Data Security — Date Completed: Equipment / Systems Operation — Date Completed: Employee Handbook Received — Date Received:

Training method: In-person Online / Webinar Self-study (materials provided)

Employment History

Education

References

Legal Notices & Disclosures

At-Will Employment: The receipt of instruction and acknowledgment contained in this document does not constitute a contract of employment. Employment remains at-will and may be terminated by either the employee or employer at any time, with or without cause and with or without notice, except as otherwise provided in a written agreement signed by an authorized company representative.

Equal Employment Opportunity: The company provides equal employment opportunity to all employees and applicants without regard to protected status. All personnel actions and decisions are made on the basis of job-related criteria.

Return of Company Property: Employee agrees that upon termination or upon request, all company property, keys, records, manuals, and confidential information must be returned immediately. Failure to return property may result in disciplinary action and may be subject to the company’s recovery procedures.

Compliance and Discipline: Failure to comply with safety rules, confidentiality obligations, or other company policies may result in corrective action up to and including termination. Employees are required to report unsafe conditions and policy violations to their supervisor or the appropriate company representative.

Authorization & Certification

Background Checks & References: I authorize the company to contact my prior employers and the references listed herein to verify information and to obtain any employment-related information necessary for the company’s evaluation. I further authorize the release of any such information to the company.

I authorize the company to conduct background checks and to contact previous employers and references as described above.

Applicant Certification: I certify that all information provided on this form is true and complete to the best of my knowledge. I understand that falsification, omission, or misrepresentation of facts may result in disciplinary action, up to and including termination of employment.

I certify that I have read, understand, and agree to the statements above.

Additional Acknowledgments

By signing below, I acknowledge receipt of the documented instruction and training indicated on this form, and I agree to comply with company policies, procedures, and safety requirements. I understand questions or concerns should be raised with my manager or the HR department.

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