Employee Sponsored Form

EMPLOYEE SPONSORED FORM

Purpose: Use this form to request company sponsorship of an external candidate or dependent for recruitment, employment eligibility assistance, training sponsorship, or benefit enrollment where employee sponsorship is required. Completion of this form obligates the sponsor to the attestations and responsibilities stated herein.

Sponsor (Employee) — Personal Information

Sponsor — Position Information

Sponsored Individual — Personal Information

Sponsored Name:    Relationship to sponsor:

Proposed Position / Sponsorship Details

Proposed start date:    Proposed annual salary / stipend:

Will sponsor provide financial guarantee for costs related to sponsorship (visa, relocation, training, etc.)? Yes No

Employment History — Sponsored Individual

Education

References — Sponsored Individual (Professional)

Legal Disclosures & Company Policies

At-Will Employment: Nothing in this form creates a contract of employment for any specified duration. If the sponsored individual is offered and accepts employment, such employment will be at-will unless a separate written agreement signed by an authorized company representative expressly provides otherwise.

Equal Opportunity: The company provides equal employment opportunity without regard to race, color, religion, sex, sexual orientation, national origin, age, disability, genetic information, or any other classification protected by law. Sponsorship does not alter the company’s equal employment policies or hiring procedures.

Confidentiality and Conflict of Interest: The sponsor acknowledges responsibility to disclose any potential conflicts of interest and to protect proprietary and confidential information. The sponsor must not receive compensation or advantage for recommending a sponsored individual that would violate company policy.

Authorization to Verify Information and Conduct Checks

By signing below the sponsor certifies that the sponsor is authorized to submit information on behalf of the sponsored individual. The sponsor expressly authorizes the company and its agents to verify all information provided on this form, including contacting former employers, educational institutions, and references; and to obtain consumer reports, criminal history, immigration status verifications, and other background checks as permitted by applicable law. The sponsor acknowledges that certain checks may require the sponsored individual’s separate consent and that such consent must be obtained before the check is initiated.

Release: The sponsor and sponsored individual release from liability any person or organization that provides information in good faith pursuant to this form and consent to the use of such information for employment and sponsorship decisions.

Applicant Certification and Sponsor Responsibilities

I certify that all information provided on this Employee Sponsored Form is true, complete, and accurate to the best of my knowledge. I understand that knowingly providing false information or material omission may result in disciplinary action, up to and including termination of employment and rescission of sponsorship. I accept responsibility for any obligations I undertake by submitting this sponsorship request, including financial commitments and facilitation of required documentation for the sponsored individual where applicable.

HR Use Only

Sponsorship request received by:    Date received:

HR review outcome: Approved Conditionally approved Denied

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