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  Policy Manual
  University of North Texas

   Classification
         Number: 16.6.2

   Date Issued: 8/25/89;
                  8/96*; 6/00*,7/03*


SUBJECT: DRUG-FREE CERTIFICATION AND AGREEMENT (FORM) 

APPLICABILITY: TOTAL UNIVERSITY

UNIVERSITY OF NORTH TEXAS
Denton, Texas

DRUG-FREE WORKPLACE CERTIFICATION AND AGREEMENT

I, __________________________________________________, hereby certify that I have been given a copy of the University of North Texas "Drug-Free Workplace Statement," that I have read and understand the requirements of the Statement, and that all my questions concerning the Statement and the Drug-Free Workplace Policy have been answered fully.

Further, I agree that, as a condition of my employment with regard to the work being performed under Federal (Grant, Contract) No. _______________________________, I will:

1. Abide by the terms of the Drug-Free Workplace Policy.

2. Notify the responsible UNT Principal Investigator/Project Director of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction.

I understand and agree that, upon such conviction, or in the event that I violate the Drug-Free Workplace Policy, UNT may take appropriate disciplinary action against me.

  ________________________________
  Employee
_________________________________________
Principal Investigator
 
  Date: ____________________________

Date: _____________________________________

*reviewed with no changes

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