Industries of Wayne and Holmes Counties, Inc.
Reciept and Confirmation of Job Description
I have reviewed the job description for the position for which I was hired and I certify that I am able to perform all of the essential functions of the job. (If the answer to this question is no, you must fill out what accommodations are needed)
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Yes
No
I have reviewed the job description for the position for which I was hired and I need the following accommodations to perform the essential functions of the job
Signature of employee
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Employee Name
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Date
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Month
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Day
Year
Date
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