Hiring Tools and Information

          Signing this form acknowledges that the employee and/or applicant has received a copy of the Company's Drug-Free Policy, has had the opportunity to discuss the Policy and have questions answered, and understands all of the provisions in the Policy. Although it reflects the Company's current Policy regarding substance use, it may be necessary to make changes from time to time at the Company's sole discretion, to best serve the needs of our organization. However, any changes deemed necessary will be made in writing, and the modified Policy will be shared with every employee and/or applicant.

          By my signature below, I acknowledge that I have received a copy of the Drug-Free Policy of the Company. I understand that it is my obligation to read, understand and comply with the procedures and provisions contained within this Policy.

          As an employee and/or applicant of the Company I hereby acknowledge that the Company's policy requires me to submit drug testing and/or breath alcohol testing to rule out the presence of non-prescribed or prohibited dangerous controlled substances in my system. I hereby freely and voluntarily consent to this request for a drug test and/or alcohol test, and agree to participate in the testing program.

          I hereby and herewith release the company, its employees, agents and contractors from any and all liability whatsoever arising from this request for testing, from the actual testing procedures, and from decisions made concerning my application for or continuation of employment based on the results of the analysis. I hereby agree to cooperate in all aspects of the testing program.

          I hereby authorize the release of my drug and/or alcohol test results to the designated Medical Review Officer (MRO), and/or to the Company's examining physician as provided by the Company's Policy.

Employee/Applicant Signature:	____________________________________
Employee/Applicant Printed Name:	____________________________________
Witness Signature:	____________________________________
Witness Printed Name:	____________________________________
Date of Signatures:	____________________________________