Policy Manual Receipt Acknowledgment

I  acknowledge that I have received a copy of the policy and procedures manual, which describes important information about [Company Name]. I understand that I should consult the Human Resource department if I have questions.

I have entered into employment with [Company Name] voluntarily and acknowledge that it is for no specified length of time. Accordingly, either I or [Company Name] may terminate the relationship at will, with or without cause, at any time, for any reason or no reason. I understand that neither this manual nor any other [Company Name] policy, practice or procedure is intended to provide any contractual obligations related to continued employment, compensation or employment contract.

Since the information, policies and benefits described here are subject to change, I acknowledge that revisions to the manual may occur, except to [Company Name]'s policy of employment-at-will. I understand that [Company Name] may change, modify, suspend, interpret or cancel, in whole or part, any of the published or unpublished policies and procedures, with or without notice, at its sole discretion, without giving cause or justification to any employee. Such revised information may supersede, modify or eliminate existing policies. The [Company Name] [job title] shall have sole authority to add, delete or adopt revisions to the policies in this manual. Any written or oral statement by a supervisor, manager or department director contrary to the personnel policy manual is invalid and should not be relied upon by any employee.

I understand and agree that I will read and comply with the policies contained in this manual and any revisions, that I am bound by the provisions contained therein, and that my continued employment is contingent on following those policies.

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Employee name (printed)

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Employee signature

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Date