I certify that all outside employment or volunteer positions I hold or which I am engaged in will not affect my job performance, such as poor job performance, absenteeism, tardiness, leaving early or refusal to work. I further certify that if the outside work activity causes or contributes to job-related problems, it must be immediately discontinued and that disciplinary procedures will be implemented to deal with specific employee infractions.
Signature of Employee: Request Date: I certify that this employee's outside employment will not interfere with his/her employment and that I hereby give my permission to enter into outside employment.
