Employment Licensure Examination Agreement

EMPLOYMENT LICENSURE EXAMINATION AGREEMENT

Parties and Purpose

This Employment Licensure Examination Agreement (Agreement) is entered into between the Employer and the Employee for the purpose of facilitating the Employee's application for, attendance at, and completion of licensure examination(s) required for performance of duties for the Employer.

Employer Name:

Employee Name:

Personal Information

Position Information

Licensure Examination Details

Examination Name:

Licensing Authority:

Scheduled Exam Date(s):

Application / Registration Deadline:

Financial Terms and Reimbursement

Employer agrees to pay the following costs:

Maximum Employer Contribution (if any): $

Reimbursement Condition: Employee shall reimburse Employer if employment terminates within months of payment; pro rata repayment will be required as provided below.

Leave, Scheduling and Reasonable Accommodations

Employer will provide approved paid/unpaid time off to attend the examination as follows:

Examination Results, Disclosure and Licensing

Employee hereby authorizes the release of examination scores and licensing determinations to the Employer: Yes

Employee agrees to obtain and maintain active licensure required for the position. Failure to obtain licensure within months may result in reassignment or termination.

Obligations and Remedies

If Employee resigns or is terminated for cause within the repayment period, Employee will reimburse Employer according to the repayment schedule above. Employee acknowledges that repayment obligation is a reasonable measure to protect Employer's investment in licensure.

Employer reserves the right to require execution of promissory note or payroll deduction authorization to enforce repayment, where permitted by law.

Employment History

Education

References

Legal Disclosures and Authorizations

At-Will Employment: Employee acknowledges and agrees that employment with Employer is at-will, and either Employer or Employee may terminate the employment relationship at any time, with or without cause or notice, except as otherwise provided in a separate written agreement signed by both parties.

Equal Opportunity: Employer is an equal opportunity employer. Employment decisions are made without regard to protected characteristics and in compliance with applicable nondiscrimination laws.

Authorization to Contact and Background Checks: Employee authorizes Employer to contact prior employers, references, and educational institutions as necessary to verify information and to conduct background checks relevant to licensure and employment. Employee further certifies that statements in this Agreement and supporting documents are true and complete.

Miscellaneous

Governing Law: This Agreement shall be governed by and construed in accordance with the laws of the state in which the Employer’s principal office is located, to the extent permitted by applicable law.

Severability: If any provision of this Agreement is held invalid or unenforceable, such provision shall be severed and the remainder of the Agreement shall remain in full force and effect.

Acknowledgment

By signing below, the parties acknowledge that they have read, understand, and agree to comply with the terms set forth in this Employment Licensure Examination Agreement.

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