Alcohol/Drug Policy Acknowledgement Form
Human Resources
FRM-U1000.07A
#
New Form
Questions about this form:
Contact
Compliance.Matters@www.edu
Authority:
POL-U1300.03
Preventing the Misuse and Abuse of Alcohol and Other Drugs Policy
SECTION I - PURPOSE OF THIS WEB FORM
All new hires are required to be given the University's
Preventing the Misuse and Abuse of Alcohol and Other Drug Policy
. It is your responsibility to read the policy to understand and follow executive leadership expectations regarding employee drug and alcohol use.
SECTION II - EMPLOYEE INFORMATION
Employee Name:
Department:
Position Title:
Supervisor:
SECTION III - EMPLOYEE ATTESTATION
Before submitting the form,
please initial each of the following
to signify your acknowledgement:
I have received the University's policy and agree to follow the policy and associated standards and
procedures. I understand that if I have any questions about the policy, I am to contact my Human
Resources Consultant.
Click here
to access the policy.
I understand that I can access the policy at any time in the future through the University's Policy
website (tip: google "WWU Policies") or the Human Resources website.
I understand I am to
immediately notify
my Human Resources Consultant if my driver's license is
suspended (temporarily or permanently)
and
one of my primary job duties is driving a University
vehicle.
I understand that I am to immediately notify my Human Resources Consultant if I am convicted of
any drug or alcohol related crime. See
Reporting Employee Drug Convictions Procedures
(
PRO- U1000.07A
)
I understand that the policy lists resources for employees that may be struggling with
alcohol/substance abuse and/or alcohol problems or has a family/significant other struggling with
alcohol/substance abuse and that I can contact the Disability Administrator in Human Resources
for assistance at any time.
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