403.6E1 - Substance Free Workplace Notice to Employees and Acknowledgement Form

EMPLOYEES ARE HEREBY NOTIFIED it is a violation of the Substance-Free Workplace policy for an employee to unlawfully manufacture, distribute, dispense, possess, use or be under the influence of in the workplace any narcotic drug, hallucinogenic drug, amphetamine, barbituate, marijuana or any other controlled substance or alcohol, as defined in federal and/or state law.

Workplace is defined as the site for the performance of work done in the capacity as an employee.  This includes school district facilities, other school district premises or school district vehicles. Workplace also includes non-school district property if the employee is at any school district sponsored, school district approved or school district related activity, event or function, such as field trips or athletic events where students are under the control of the school district or where the employee is engaged in school district business.

Employees who violate the terms of the substance-free workplace policy may be required to successfully participate in a substance abuse treatment program approved by the board.      The superintendent retains the discretion to discipline an employee for violation of the substance-free workplace policy. If the employee fails to successfully participate in such a program the employee shall be subject to discipline up to and including termination.

EMPLOYEES ARE FURTHER NOTIFIED it is a condition of their continued employment that they comply with the above policy of the school district and will notify their supervisor of their conviction of any criminal alcohol or drug offense in any setting , no later than five days after the conviction.

SUBSTANCE-FREE WORKPLACE ACKNOWLEDGMENT FORM

I, ___________________________, have read and understand the substance-free workplace policy.  I understand that if I violate the substance-free workplace policy, I may be subject to discipline up to and including termination or I may be required to participate in a substance abuse treatment program.  I understand that if I am required to participate in a substance abuse treatment program and if I fail to successfully participate in a substance abuse treatment program or I refuse to participate, I understand I may be subject to discipline up to and including termination.   I also understand that if I am convicted of a criminal alcohol or drug offense in any setting, I must report that conviction to my supervisor within five days of the conviction.

_______________________________________                              ___________________________
(Signature of Employee)                                                                                      (Date)