External Employment Application

We understand new opportunities for growth may come your way. Any employee seeking to complete professional work outside of their role at Organization must submit this application to their manager, the HR/Operations Team for approval by the Board. This form is intended to ensure transparency and assess any potential conflicts or intellectual property issues that may arise from external work performed by employees. All employees engaging in outside work (paid or unpaid) must complete this form.

Completed applications will be submitted to The Executive Director and The Board for review. All applications will be reviewed on a rolling basis. Applicants will be notified of the status of their applications via email once final approval is received.

Name

Job Title

Manager/Supervisor

Name of Outside Employer/Project/Business

Type of Entity

Text

Nature and scope of work

Industry or Sector

Start Date of Engagement

Estimated Weekly Time Commitment

Did you already seek approval from your manager for this work?YesNo

Please attach approval document.

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Does the external work involve a company, product, or service that competes with Organization? IYesNo

If Yes, please explain.

Does the work involve any client, vendor, or partner of Organization?YesNo

If yes, please describe the nature of interaction.

Do you use any Organization property or resources for pursuing this work?YesNo

If yes, please provide details.

Does the work occur during your normal working hours with Organization?YesNo

Do you expect to use any confidential information, methods or tools obtained at Organization in this work?YesNo

Please explain.

By signing below, I certify that the information provided is accurate and complete to the best of my knowledge. I understand that material misrepresentation or failure to disclose may lead to disciplinary action. I acknowledge that if my performance at Organization is impacted I will be asked to stop work, being able to choose internal or external work. I agree to abide by all Organization policies including those related to confidentiality, conflict of interest , and intellectual property.

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