Request For Outside Employment Form Name Date Department Title I hereby request approval to engage in outside employment as described below:Nature of employment: Time required for employment: I understand that The Adult Education Center, Inc. (“Center”) policy forbids me from engaging in any form of outside employment or business opportunity, for myself or another employer, which would conflict or interfere with my job especially while on company time. Additionally, I understand that using organization equipment or materials for outside employment is strictly prohibited. I understand that in order to engage in outside employment, I must receive approval from my supervisor or President & CEO in advance of performing such outside employment, and that the approval may be withdrawn at any time. I also understand and agree that my outside employment must be suspended if my work status with the Center is sick leave, FMLA leave as applicable, workers compensation leave or restricted duty. I understand that failure to comply with the policy could result in disciplinary action up to and including immediate termination of employment on the first offense.Employee SignatureDate MM slash DD slash YYYY TO BE PLACED IN EMPLOYEE’S PERSONNEL FILEEmailThis field is for validation purposes and should be left unchanged.
