Applicants Statement: ( to be signed at interview)
Bethany Lutheran Home is committed to providing a drug and alcohol free environment. The use, possession, transfer or sale of illegal drugs or alcohol is not permitted on Bethany's property, either on or off duty. By my signature, I hereby give my consent to provide a urine sample or take a breath test to test for drugs and/ or alcohol, if requested by facility.
I further understand, that any offer of, or continued employment is contingent upon:
Applicant's Signature Date