Employment Offer Execution Form

EMPLOYMENT OFFER EXECUTION FORM

Employer Name:     Applicant Name:

Offer Date:     Offer Valid Until:

Position and Terms

Job Title:     Department:

Proposed Start Date:     Work Location:

Full-Time    Part-Time    Temporary/Contract    Exempt:    Non-Exempt:

Compensation and Benefits

Weekly    Bi-weekly    Semi-monthly    Monthly

Conditions of Offer

This offer is contingent upon satisfactory completion of pre-employment requirements, which may include: criminal background check, reference verification, drug screening, and verification of eligibility to work in the United States. The candidate must furnish required documentation on or before the first day of employment. Failure to satisfy these conditions may result in withdrawal of the offer or termination of employment.

Contingency - Background Check:    Contingency - Drug Screen:    Contingency - Reference Verification:

Probationary Period (if applicable):

Legal Notices and Acknowledgments

At-Will Employment: The employment relationship between the Employer and the Applicant is at-will and may be terminated by either party at any time, with or without cause or notice, unless otherwise expressly provided in a written agreement signed by an authorized representative of the Employer.

Equal Opportunity Employer: The Employer is an equal opportunity employer. Decisions regarding recruitment, hiring, advancement, and benefits are made without regard to race, color, religion, sex, national origin, age, disability, genetic information, or any other characteristic protected by applicable law.

Confidentiality and Proprietary Information: As a condition of employment, the Applicant will be required to abide by the Employer's policies regarding confidential and proprietary information. The Applicant acknowledges that obligations respecting such information survive termination of employment.

Personal Information

Employment History (Most Recent)

Dates Employed From: To:

Dates Employed From: To:

Education

Graduation Date:     Major/Field:

Professional References

Applicant Certifications and Authorizations

I certify that all information provided in this form and any attachments is true, complete, and correct to the best of my knowledge. I understand that any material misrepresentation or omission may be grounds for rescission of this offer or termination of employment.

Authorization to Contact Prior Employers and References: I authorize the Employer and its agents to contact my prior employers, educational institutions, and listed references to verify information and obtain any facts or evaluations relevant to my employment. I release all parties from liability for providing such information.

Consent for Background Screening: By accepting this offer, I consent to any pre-employment screening required by the Employer, including criminal background checks and drug testing. I understand that any adverse information may affect my eligibility for employment.

I certify that the foregoing statements are true and authorize the described verifications.

Acceptance

To accept this offer, sign and date below and return a signed copy to the Employer by the Offer Valid Until date. By signing, the Applicant agrees to the terms set forth in this document and acknowledges the conditions noted above.

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