Employee Intern Orientation Packet

EMPLOYEE INTERN ORIENTATION PACKET

Personal Information

Preferred Name:    Date of Birth:

Phone:    Email:

Emergency Contact

Relationship:    Phone:

Position & Assignment

Reporting Supervisor:    Supervisor Title:

Start Date:    End Date (if applicable):

Orientation Checklist (To be completed by HR / Supervisor)

ID Badge Issued — Date:

Building / Access Credentials Activated — Date:

Computer Account & Email Provisioned — Date:

Safety / Emergency Procedures Training Completed — Date:

Confidentiality & Data Handling Training Completed — Date:

Job Description & Objectives Provided — Date:

Workspace / Equipment Assigned — Date:

Employment History

Employer 1

Title:    From:    To:

Employer 2

Title:    From:    To:

Education

Major / Field:    Graduation Date:

Professional References (Provide 3)

Reference 1

Relationship:    Phone:    Email:

Reference 2

Relationship:    Phone:    Email:

Reference 3

Relationship:    Phone:    Email:

Legal Disclosures & Acknowledgements

At-Will Acknowledgment: I understand and acknowledge that my internship is at-will and may be terminated by either party at any time, with or without cause or notice, unless otherwise provided in a separate written agreement signed by an authorized representative. I further acknowledge that no representative of the organization other than an authorized officer has the authority to alter this at-will relationship.

I acknowledge receipt and understanding of the At-Will statement.

Equal Opportunity: The organization provides equal employment opportunities and will not tolerate discrimination or harassment on the basis of race, color, religion, sex, national origin, age, disability, veteran status, or any other characteristic protected by applicable law. All personnel actions are administered without discrimination.

I acknowledge receipt and understanding of the Equal Opportunity statement.

Confidentiality & Proprietary Information: During the course of my internship I may have access to confidential, proprietary, or trade secret information. I agree to hold such information in confidence both during and after my internship and not to disclose or use such information except as required in the performance of my duties. I acknowledge that intellectual property developed in the scope of my internship may be owned by the organization to the extent permitted by law.

I acknowledge and agree to the Confidentiality & Proprietary Information terms.

Background Check & Reference Authorization: I authorize the organization to contact prior employers, educational institutions, and references to verify statements made and to obtain information concerning my background, work performance, and suitability for the position. I authorize the release of records and information to the organization and release those parties from liability for furnishing such information. I understand that information obtained may be considered in determining my eligibility for continued participation in the internship program.

I consent to background and reference checks as described above.

Receipt of Policies & Materials

I acknowledge that I have been provided with, or have access to, the organization’s workplace policies relevant to my internship including safety procedures, code of conduct, and IT acceptable use policies. I understand it is my responsibility to review these policies and to comply with them.

Employee Handbook or Policy Summary provided

Safety Manual provided

IT / Acceptable Use Policy provided

Applicant Certification

I certify that the information contained in this orientation packet and any attachments is true, accurate and complete to the best of my knowledge. I understand that any misrepresentation or omission may result in denial or termination of the internship. I authorize the organization to verify the information provided and to make any inquiries necessary in connection with my application and participation.

I certify that the information provided is true and complete.

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