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Series 406.3.5.1P - Pre-test Acknowledgement Form for Employees Not Performing Duties Requiring a Commercial Driver's License

 

Date____________________

I, the undersigned employee of Independent School District 196, do hereby acknowledge that I have been provided a copy of:

  • Policy 406, Section 3, Chemical-Free Workplace; and
  • Administrative Regulation 406.3.5AR, Alcohol and Drug Testing of Employees Not Performing Duties Requiring a Commercial Driver’s License (CDL).

Signature of employee ________________________________________

Typed or printed name of employee ______________________________

Employee number ___________________

Procedures/406.3.5.1P/02-09-15