HR Rules and Waivers Form

HR RULES AND WAIVERS FORM

Personal Information

Position Information

Reporting Manager:    Anticipated Start Date:

Employment History (Most Recent)

Employment History (Previous)

Education

References

Company Rules — Acknowledgment

I acknowledge receipt of and agree to comply with the employer's policies, rules, and code of conduct, including but not limited to workplace safety, harassment prevention, data protection, and acceptable use of company property. I understand that these rules are not a contract of employment and that employment is at-will unless otherwise agreed in writing.

I have reviewed the following key workplace rules and will adhere to them: 1) Maintain a safe work environment; 2) Follow attendance and punctuality requirements; 3) Report suspected harassment or discrimination; 4) Protect confidential information; 5) Use company property for authorized purposes only; 6) Comply with applicable safety protocols and personal protective equipment requirements.

I acknowledge that I have received and will review the employee handbook and related policies and will comply with all workplace rules and directives.

Waivers, Consents, and Authorizations

The provisions below describe specific waivers and authorizations. By checking the applicable boxes and signing, I knowingly and voluntarily consent to the items I select. These provisions are severable: if any portion is found unenforceable, the remainder remains effective.

I authorize the employer to obtain consumer reports, background checks, and verification of employment, education, and references. I understand this may include criminal history, driving records, and other job-related screenings where permitted by law.

I consent to pre-employment and reasonable suspicion drug and alcohol testing in accordance with company policy. I understand refusal to test may affect hiring or continued employment.

I agree to maintain the confidentiality of employer proprietary and confidential information both during and after employment and to return all employer property upon separation.

I accept responsibility for care and reasonable use of company-issued equipment. I understand I may be held financially responsible for loss or negligent damage to assigned equipment to the extent permitted by law.

I grant permission to the employer to use photographs or video that may include my likeness for internal communications, training, and promotional materials, unless I indicate otherwise in writing.

I agree that, except as prohibited by law, employment-related disputes may be resolved exclusively through final and binding arbitration pursuant to the company's arbitration policy rather than by jury trial. This agreement does not preclude filing charges with governmental agencies where such filing is permitted.

Legal Disclosures

At-Will Employment: I understand that unless expressly provided otherwise in a separate written agreement signed by an authorized company representative, my employment is at-will and may be terminated by either party at any time, with or without cause and with or without notice.

Equal Opportunity: The employer is an equal opportunity employer and does not unlawfully discriminate on the basis of race, color, religion, sex, national origin, age, disability, veteran status, or other protected characteristics. Reasonable accommodations may be available upon request consistent with applicable law.

Applicant Certification and Authorization

I certify that all information in this form and any accompanying documents is true, complete, and correct to the best of my knowledge. I understand that any false, misleading, or omitted information may be grounds for refusal of employment or termination of employment. I authorize my previous employers, educational institutions, and listed references to provide information regarding my background and qualifications.

Consent Summary (Initial Where Indicated)

By initialing below I confirm that I have read and consent to each checked item above and that I understand the consequences of the selected waivers.

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