Appendix
APPLICANT'S CONSENT TO DRUG/ALCOHOL TESTING

I understand it is the policy of the company/organization to conduct drug and/or alcohol tests of job applicants for the purpose of detecting drug and/or alcohol abuse, and that one of the requirements for consideration of employment with the company/organization is the satisfactory passing of the company's/organization's drug and/or alcohol test(s).

For the purpose of being further considered for employment, I hereby agree to submit to a drug and/or alcohol test.

I understand that favorable test results will not necessarily guarantee that I will be employed by the company/organization.

If I am accepted for employment, I agree to take drug and/or alcohol tests whenever requested by the company/organization, and I understand that the taking of such tests is a condition of my continued employment.

I also give consent to the testing agency to release to the company/organization and other officially interested parties the results of my tests.

At this time I consent to a drug and/or alcohol test.

______________________________________________________________ (Signature)                                     (Date signed)

______________________________________________________________ (Printed name)                                (Signature of witness)

NOTE: This form should be customized with your company or organization's name and should reference only drugs or alcohol, or both, depending upon which options you select for testing requirements.