ACKNOWLEDGEMENT OF RECEIPT

OF DRUG/ALCOHOL POLICY

This is to acknowledge that I have received a copy of PHK CPA's Drug/Alcohol Policy. I understand that, as a condition of my employment, I may not report to work ...

I understand that, from time to time, I may be requested to take drug/alcohol...

By accepting and/or continuing my employment with PHK CPA, I agree to be ...

__________________________

Signature of Applicant/Employee

__________________________

Print Name of Employee/Applicant

Date: ______________

Witness: ____________________