Employment Integrity Pact Form

EMPLOYMENT INTEGRITY PACT FORM

Applicant Name:

Personal Information

Position Information

Proposed Start Date:    Proposed Salary:

Employment History

Employer 1

From:    To:

Employer 2

From:    To:

Education

Graduation Date:

Professional References

Integrity Pledge and Declarations

As a condition of consideration for employment, I hereby declare and agree to the following provisions of this Employment Integrity Pact (the "Pact"). I understand that adherence to these provisions is material to any offer of employment and, if employed, to continued employment.

Core Commitments

1. Prohibition on Corrupt Practices: I will not, directly or indirectly, offer, give, solicit, or accept any bribe, kickback, improper gift, or other corrupt payment to obtain or retain business or to secure any improper advantage in the performance of my duties.

2. Conflicts of Interest: I will promptly disclose in writing any personal, financial, or other interest that could reasonably be expected to create a conflict between my interests and those of the employer. I certify that, to the best of my knowledge, I have no undisclosed conflicts other than those listed here:

3. Accurate Representations: All information provided in connection with my application and this Pact is true, complete, and accurate. I understand that materially false, misleading, or omitted information may result in withdrawal of an offer or termination of employment.

4. Confidentiality and Use of Company Information: I will not disclose or misuse confidential or proprietary information obtained during the application process or employment, except as required by law or authorized by the employer in writing.

Reporting, Investigations, and Cooperation

I agree to promptly report any suspected violations of this Pact to the employer and to cooperate fully and truthfully with any internal or external investigation. I understand that the employer will take allegations seriously and will investigate in a manner consistent with applicable law and policy.

I understand that retaliation against individuals who, in good faith, report potential violations or cooperate with investigations is prohibited and that the employer will take appropriate steps to protect reporting parties in accordance with policy and law.

Background Checks and Authorizations

I authorize the employer and its agents to investigate my background, including criminal history, employment verification, education verification, and reference checks. I consent to the release of information requested in connection with such investigations and understand that employment is contingent on satisfactory completion of any required checks.

Criminal Conviction History: Have you ever been convicted of a felony or a crime involving moral turpitude?   Yes   No    If yes, provide details:

Authorization to Contact Past Employers: I authorize the employer to contact my prior employers and references.

Legal Notices and Acknowledgments

At-Will Employment: I acknowledge that, unless expressly set forth in a separate, written agreement signed by an authorized representative of the employer, my employment (if any) will be at-will, which means either I or the employer may terminate the employment relationship at any time, with or without cause and with or without notice.

Equal Opportunity: The employer is an equal opportunity employer. Decisions regarding hiring, promotion, compensation, and other terms of employment are made without unlawful discrimination.

Consequences of Breach: I understand that violation of this Pact, or falsification of information provided in connection with my application or employment, may result in withdrawal of any offer, denial of employment, or disciplinary action up to and including termination, in addition to any civil or criminal penalties that may apply.

Applicant Certification

I certify under penalty of perjury that the foregoing statements are true and correct to the best of my knowledge. I acknowledge that I have read and understand the terms of this Employment Integrity Pact and agree to comply with its provisions as a condition of employment consideration and, if employed, continued employment.

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