TARLETON STATE UNIVERSITY
Employment Packet for New Student Employees
Table of Contents
Tarleton Student and Non-Budgeted Hourly Application for Employment .................................................. 2
Employee Personal Data ................................................................................................................................ 3
Disabled Veteran Status ................................................................................................................................ 5
Voluntary Statement of Disability ................................................................................................................ 7
Statement of Previous State Employment ..................................................................................................... 9
Employee’s Withholding Allowance Certificate (IRS W-4) ....................................................................... 10
Article IX .................................................................................................................................................... 12
Texas Government Code ............................................................................................................................. 14
Notice to Employees of Workers Compensation Insurance ........................................................................ 16
Direct Deposit and Electronic W-2 Authorization Form ............................................................................ 17
Security Sensitive Position Verification/Background Check Authorization ............................................... 18
Hiring Checklist for Student Workers, Work Study, and Hourly Employees ............................................. 19
Confidentiality of Education Records ......................................................................................................... 20
Confidentiality Statement, Student Employee ............................................................................................ 22
Statement of Selective Service Registration Status ..................................................................................... 23
Minor’s Employment Release ..................................................................................................................... 24
Policies
Drug and Alcohol Abuse, Rule 34.02 ........................................................................................... 25
Drug and Alcohol Abuse and Rehabilitation Programs, Rule 34.02.01 ....................................... 27
Drug and Alcohol Abuse Prevention, Rule 34.02.01.T1 ............................................................... 33
Prevention of Alcohol Abuse and Illicit Drug Use (Tarleton State University) .................................... 37
Sexual and Other Gender-Based Misconduct ............................................................................... 40
AIDS in the Workplace ............................................................................................................................... 44
Notice to Employees, Texas Hazard Communication Act .......................................................................... 46
Overview of Voluntary Supplemental Savings Programs ............................................................................ 48
Campus Carry ............................................................................................................................................. 52
** Bring completed documents with you to Student Orientation **
Department of Employee Services
Tarleton State University
Stephenville Campus | Admin Annex
254.968.9128
Contact:
Mar y Chenault, 254-968-9905 or Kandace Stone, 254-968- 9913
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HR 181 (9/15)
This employer is a Government contractor subject to the Vietnam Era Veterans’ Readjustment Assistance Act of 1974, as
amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), which requires Government contractors to take affirmative
action to employ and advance in employment: (1) disabled veterans; (2) recently separated veterans; (3) active duty wartime or
campaign badge veterans; and (4) Armed Forces service medal veterans [41 CFR 60-300.5(a)].
As a Government contractor subject to VEVRAA, we are required to submit a report to the United States Department of Labor
each year identifying the number of our employees belonging to each specified “protected veteran” category. If you believe you belong
to any of the categories of protected veterans listed, please indicate by checking the appropriate box (choose all that apply).
If you are a disabled veteran, it would assist us if you tell us whether there are accommodations we could make that would enable
you to perform the essential functions of the job, including special equipment, changes in the physical layout of the job, changes in the
way the job is customarily performed, provision of personal assistance services or other accommodations. This information will assist
us in making reasonable accommodations for your disability. Submission of this information is voluntary and refusal to provide it will
not subject you to any adverse treatment. The information provided will be used only in ways that are not inconsistent with VEVRAA,
as amended.
The information you submit will be kept confidential, except that (i) supervisors and managers may be informed regarding
restrictions on the work or duties of disabled veterans, and regarding necessary accommodations; (ii) first aid and safety personnel
may be informed, when and to the extent appropriate, if you have a condition that might require emergency treatment, and (iii)
Government officials engaged in enforcing laws administered by the Office of Federal Contract Compliance Programs, or enforcing the
Americans with Disabilities Act, may be informed.
Protected veterans may have additional rights under USERRA – the Uniformed Services Employment and Reemployment Rights
Act. In particular, if you were absent from employment in order to perform service in the uniformed service, you may be entitled to be
reemployed by your employer in the position you would have obtained with reasonable certainty if not for the absence due to
service. For more information, call the U.S. Department of Labor’s Veterans Employment and Training Service (VETS), toll-free, at 1866-4-USA-DOL.
The following definitions are provided for your information and assistance in completing the Employee Personal Data form:
EEO Ethnicity/Race
 Hispanic or Latino. A person of Cuban, Mexican, Puerto
Rican, South or Central American, or other Spanish culture
or origin, regardless of race.
 White. (Not Hispanic or Latino) A person having origins in
any of the original peoples of Europe, the Middle East, or
North Africa.
 Black or African American. (Not Hispanic or Latino) A
person having origins in any of the Black racial groups of
Africa.
 Asian. (Not Hispanic or Latino) A person having origins in
any of the original peoples of the Far East, Southeast Asia,
or the Indian Subcontinent including, for example,
Cambodia, China, India, Japan, Korea, Malaysia, Pakistan,
the Philippine Islands, Thailand, and Vietnam.
 American Indian or Alaska Native. (Not Hispanic or
Latino) A person having origins in any of the original
peoples of North and South America (including Central
America) and who maintains tribal affiliation or community
attachment.
 Native Hawaiian or Other Pacific Islander. (Not Hispanic
or Latino) A person having origins in any of the original
peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
*Veteran Status
 Veteran. The individual has served in the army, navy, air
force, coast guard, or marine corps of the United States or
the United States Public Health Service, the Texas military
forces, or an auxiliary service of one of those branches of the
armed force, and who has been honorably discharged from
the branch of the service in which the person served.
 Armed Forces Service Medal Veteran. The individual is a
veteran who, while serving on active duty in the U.S. military,
ground, naval or air service, participated in a United States
military operation for which an Armed Services Medal was
awarded pursuant to Executive Order 12985 (61 Fed. Reg.
1209).
 Active Duty Wartime or Campaign Badge Veteran. The
individual has served on active duty in the U.S. military,
ground, naval or air service during a war or in a campaign or
expedition for which a campaign badge has been authorized,
under the laws administered by the Department of Defense.
A list of campaigns and expeditions meeting this criteria is
on Page 4.
 Recently Separated Veteran. The individual is any veteran
during the three-year period beginning on the date of such
veteran’s discharge or release from active duty in the U.S.
military, ground, naval or air service.
 Orphan of a Veteran. The individual is an orphan of a
veteran if the veteran was killed on active duty.
 Surviving Spouse of a Veteran. The individual is a
surviving spouse of a veteran who has not remarried.
I have read and understand this material and I certify that the information provided by me is true and correct to the best of my
knowledge. This document is executed in good faith.
Original Signature Required
Employee signature
Date
The Texas A&M University System is an Equal Opportunity/Affirmative Action/Veterans/Disability Employer.
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Voluntary Self-Identification of Disability
Form CC-305
OMB Control Number 1250-0005
Expires 1/31/2020
Page 1 of 2
Why are you being asked to complete this form?
Because we do business with the government, we must reach out to, hire, and provide equal opportunity to
qualified people with disabilities.i To help us measure how well we are doing, we are asking you to tell us if you
have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will
choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used
against you in any way.
If you already work for us, your answer will not be used against you in any way. Because a person may
become disabled at any time, we are required to ask all of our employees to update their information every five
years. You may voluntarily self-identify as having a disability on this form without fear of any punishment
because you did not identify as having a disability earlier.
How do I know if I have a disability?
You are considered to have a disability if you have a physical or mental impairment or medical condition that
substantially limits a major life activity, or if you have a history or record of such an impairment or medical
condition.
Disabilities include, but are not limited to:
Blindness
Deafness
Cancer
Diabetes
Epilepsy
Autism
Cerebral palsy
HIV/AIDS
Schizophrenia
Muscular
dystrophy
Bipolar disorder
Major depression
Multiple sclerosis (MS)
Missing limbs or
partially missing limbs
Post-traumatic stress disorder (PTSD)
Obsessive compulsive disorder
Impairments requiring the use of a wheelchair
Intellectual disability (previously called mental
retardation)
Please check one of the boxes below:
☐
YES, I HAVE A DISABILITY (or previously had a disability)
☐
NO, I DON’T HAVE A DISABILITY
☐
I DON’T WISH TO ANSWER
__________________________
Your Name
__________________
Today’s Date
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Voluntary Self-Identification of Disability
Form CC-305
OMB Control Number 1250-0005
Expires 1/31/2020
Page 2 of 2
Reasonable Accommodation Notice
Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities.
Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples
of reasonable accommodation include making a change to the application process or work procedures,
providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.
i
Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal
employment obligations of Federal contractors, visit the U.S. Department of Labor’s Office of Federal Contract
Compliance Programs (OFCCP) website at www.dol.gov/ofccp.
PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required
to respond to a collection of information unless such collection displays a valid OMB control number. This
survey should take about 5 minutes to complete.
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Article IX
Printed Name: ____________________________________
Social Security Number: ________________________________
Article IX of the Appropriations Act passed by the 75th Legislature requires that The
Texas A&M University System distribute to you the information printed below. In
addition, we are required to collect form you your signed statement that you have received
this information.
Political Aid and Legislative Influence Prohibited (Section 5). None of the moneys
appropriated by this Act, regardless of their source or character, shall be used for
influencing the outcome of any election, or the passage or defeat of any legislative
measure. This prohibition shall not be construed to prevent any official or employee of the
state from furnishing to any Member of the Legislature or committee upon request, or to
any other state official or employee or to any citizen information in the hands of the
employee or official not considered under law to be confidential information. Any action
taken against an employee or official for supplying such information shall subject the
person initiating the action to immediate dismissal from state employment.
No funds under the control of any state agency or institution, including but not limited to,
state appropriated funds, may be used directly or indirectly to hire employees or in any
other way fund or support candidates for the legislative, executive, or judicial branches of
government of The State of Texas or the government of the United States.
None of the funds appropriated by this Act shall be expended in payment of the salary for
full-time employment of any state employee who is also the paid lobbyist of any
individual, firm, association or corporation. None of the funds appropriated by this Act
shall be expended in payment of the partial salary of a part-time employee who is required
to register as a lobbyist by virtue of the employee’s activities for compensation by or on
behalf of industry, a profession or association related to operation of the agency or
institution for which the person is employed. A part-time employee may serve as a lobbyist
on behalf of industry, a profession or association so long as such entity is not related to the
agency with which he or she is employed.
Except as authorized by law, none of the funds appropriated by this Act shall be expended
in payment of membership dues to an organization on behalf of the agency or an employee
of an agency if the organization pays all or part of the salary of a person required to
register under Chapter 305, Government Code.
No employee of any state agency shall use any state-owned automobile except on official
business of the sate, and such employees are expressly prohibited from using such
automobile in connection with any political campaign or any personal or recreational
activity.
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Article IX, continued.
None of the moneys appropriated by this Act shall be paid to any official or employee who
violates any of the provisions of this section.
Standards of Conduct for State Employees (Section 6). None of the funds
appropriated by this Act shall be expended to pay the salary of a state employee who:
(1) accepts or solicits any gift, favor or service that might reasonably tend to
influence the employee in the discharge of official duties or that the employee
knows or should know is being offered with the intent to influence the
employee’s official conduct;
(2) Accepts other employment or engages in a business or professional activity
that the employee might reasonably expect would require or induce the
employee to disclose confidential information acquired by reason of the
official position;
(3) Accepts other employment or compensation that could reasonably be expected
to impair the employee’s independence of judgment in the performance of the
employee’s official duties;
(4) Makes personal investments that could reasonably be expected to create a
substantial conflict between the employee’s private interest and the public
interest; or,
(5) Intentionally or knowingly solicits, accepts or agrees to accept any benefit for
having exercised the employee’s official powers or performed the employee’s
official duties in favor of another.
Acknowledgement:
I have received and read the above excerpts of Sections 5 and 6 of Article IX, HB 1, 75th
Legislature (1997).
__________________________________
Signature
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_________________
Date
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Texas Government Code
Chapter 556: Political Activities by Certain Public Entities and Individuals
Sec. 556.004 PROHIBITED ACTS OF AGENCIES AND INDIVIDUALS.
(a) A state agency may not use any money under its control, including appropriated money, to finance
or otherwise support the candidacy of a person for an office in the legislative, executive, or judicial
branch of state government or of the government of the United States. This prohibition extends to
the direct or indirect employment of a person to perform an action described by this subsection.
(b) A state officer or employee may not use a state-owned or state-leased motor vehicle for a purpose
described by Subsection (a).
(c) A state officer or employee may not use official authority or influence or permit the use of a
program administered by the state agency of which the person is an officer or employee to interfere
with or affect the result of an election or nomination of a candidate or to achieve any other political
purpose.
(d) A state employee may not coerce, attempt to coerce, command, restrict, attempt to restrict, or
prevent the payment, loan, or contribution of any thing of value to a person or political organization
for a political purpose.
(e) For purposes of Subsection (c), a state officer or employee does not interfere with or affect the
results of an election or nomination if the individual's conduct is permitted by a law relating to the
individual's office or employment and is not otherwise unlawful.
Sec. 556.005 EMPLOYMENT OF LOBBYIST.
(a) A state agency may not use appropriated money to employ, as a regular full-time or part-time or
contract employee, a person who is required by Chapter 305 to register as a lobbyist. Except for an
institution of higher education as defined by Section 61.003, Education Code, a state agency may
not use any money under its control to employ or contract with an individual who is required by
Chapter 305 to register as a lobbyist.
(b) A state agency may not use appropriated money to pay, on behalf of the agency or an officer or
employee of the agency, membership dues to an organization that pays part or all of the salary of a
person who is required by Chapter 305 to register as a lobbyist. This subsection does not apply to
the payment by a state agency of membership fees under Chapter 81.
(c) A state agency that violates Subsection (a) is subject to a reduction of amounts appropriated for
administration by the General Appropriations Act for the biennium following the biennium in
which the violation occurs in an amount not to exceed $100,000 for each violation.
(d) A state agency administering a statewide retirement plan may enter into a contract to receive
assistance or advice regarding the qualified tax status of the plan or on other federal matters
affecting the administration of the state agency or its programs if the contractor is not required by
Chapter 305 to register as a lobbyist.
Sec. 556.0055. RESTRICTIONS ON LOBBYING EXPENDITURES.
(a) A political subdivision or private entity that receives state funds may not use the funds to pay:
(1) lobbying expenses incurred by the recipient of the funds;
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Texas Government Code, Continued.
(2) a person or entity that is required to register with the Texas Ethics Commission under
Chapter 305;
(3) any partner, employee, employer, relative, contractor, consultant, or related entity of a
person or entity described by Subdivision (2); or
(4) a person or entity that has been hired to represent associations or other entities for the
purpose of affecting the outcome of legislation, agency rules, ordinances, or other
government policies.
(b) A political subdivision or private entity that violates Subsection (a) is not eligible to receive
additional state funds.
Sec. 556.006. LEGISLATIVE LOBBYING
(a) A state agency may not use appropriated money to attempt to influence the passage or defeat of a
legislative measure.
(b) This section does not prohibit a state officer or employee from using state resources to provide
public information or to provide information responsive to a request.
Sec. 556.007. TERMINATION OF EMPLOYMENT
A state employee who causes an employee to be discharged, demoted, or otherwise discriminated
against for providing information under Section 556.006(b) or who violates Section 556.004(c) or (d) is
subject to immediate termination of employment.
Sec. 556.008. COMPENSATION PROHIBITION.
A state agency may not use appropriated money to compensate a state officer or employee who violates
Section 556.004(a), (b), or (c) or Section 556.005 or 556.006(a), or who is subject to termination under
Section 556.007.
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Supervisors:
Hiring Checklist For
Student Workers, Work Study Students and Hourly Employees
3. Confidentiality Issues
2. Work Expectations within the Department
1. Departmental Goals
_____
_____
_____
_____
9. Copies of Social Security Card, Driver’s License (or photo
ID)
_____
8. Safety Issues
7. Time Sheets/ Due Dates
6. Appropriate Attire
_____
_____
_____
Please complete the training below with each new employee in your department. Complete, date and sign the form, and return it to the Tarleton Human Resources Department, Box T-0510 along with the complete employment packet and PAF. This for m will be placed in the individual's per sonnel file.
4. Customer Service
_____
_____
5. Equipment Use
10. Other (Immigration documentation , etc.)
In addition to the above topics, your new employees will also need to complete two mandatory training modules online, Creating a Discrimination Free
Workplace and Ethics. They will access these modules on the HRConnect Training web page accessed through Single Sign On (SSO). Instructions for first
time SSO users are located at www.tarleton.edu/~training/online.html. For students, the Employee UIN and Student UIN will be different numbers. Your
new employee’s UIN will be written on the copy of the PAF returned to the department once the employment packet and PAF are processed. If you have
any difficulty in accessing these training modules, please contact the Human Resources office immediately for assistance.
(Print Employee Name)
I , ___________________________________, a newly employed student worker, Work Study student, or hourly wage
(Print Department Name)
employee, hired by the _______________________________ Department, understand that I must complete both mandatory
__________________________________________
__________________________________________
Employee Signature
Date
_______________________
_______________________
Date
orientation trainings Creating A Discrimination Free W orkplace and Ethics within 10 days of my hire date.
Supervisor
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Student Records Policies and Procedures
Confidentiality of Education Records
UNIVERSITY POLICY STATES THAT UNDER NO CIRCUMSTANCE SHOULD YOUR
PASSWORD BE SHARED WITH OTHER EMPLOYEES OR STUDENT WORKERS!
1.
General
The Family Educational Rights and Privacy Act (FERPA) of 1974 is a federal law that grants to
students the right to inspect, to obtain copies, to challenge and to a degree control the release of
information contained in his or her education records. The act and regulations are very lengthy and
for that reason Tarleton State University has issued Guidelines which are available to students in
the Office of the Dean of Students. Students are urged to acquaint themselves with the guidelines.
2. Directory Information
The following Directory Information may be given out without the student’s consent:
A. Personal Data
Includes Student’s mailing address, all telephone numbers, email, and date of birth.
B. Enrollment Data
Includes Student’s academic program (School of record, degree objectives, majors, minors,
and anticipated date of graduation), classification, dates of attendance, degrees and awards
received, and previous educational agency or institution(s) attended.
C. Athletic Participation Data
Includes participation in officially recognized activities and sports, and weight and height
of members of athletic teams.
Items/data not designated directory information can only be released with the consent of the
student or without the consent of the student in a few specific situations, such as dependent of
parent.
Students have the right to limit and restrict the release of this information by notifying the
Office of the Registrar. Requests for restriction of Directory Information items are to be filled
out in person, on the appropriate form, within 10 days after the first class day.
3. Parental Certification of Student Dependency
The Family Education Rights and Privacy Act restricts Tarleton State University from
releasing academic information to anyone, including parents, without the student’s
permission to release such information. FERPA permits an exemption to this policy when
the parents claim the student as a dependent on their income tax forms under the rules of
section 152 of the Internal Revenue Code of 1954. Parents must complete a Parental
Certification form in the Office of the Registrar annually to certify the dependency of their
son or daughter and to be eligible to receive academic information upon request.
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Student Records Policies and Procedures
Confidentiality of Education Records
4. Release of Information on Campus
The Act does allow release of information to faculty, staff, and other students of the
institution, but ONLY on a bona fide “need to know” basis. What constitutes a bona fide
“need to know” can be unclear and at times there can be differing interpretations. “Need to
know” means that the information is needed for the staff, faculty, or student to carry out
their Tarleton function. It does not include staff, faculty, or student to carry out their
Tarleton function. It does not include “would like to know.” There must be a clear
relationship between obtaining the information and the successful meeting of assigned
Tarleton job responsibilities.
Each staff member is responsible to release information only upon the careful
determination that the information is needed for a bona fide “need to know” reason and to
request information for our use with a “need to know.”
The most common possible abuse of student information comes from employees or
students who have family members, friends or acquaintances as students.
“Need to Know” must be established prior to releasing any confidential information.
Remember, that if it isn’t one of the Directory Information items then it is confidential. If
in doubt, then DON’T release the information without consulting with your supervisor.
Reports that contain confidential student information, anything that isn’t Directory
Information, should have a cover memo and/or notation on the report stating that the
information contained in the report is confidential, provided on a “Need to Know’ basis,
cannot be released to non-Tarleton State University persons and can only be released to
other Tarleton State University persons on a “Need to Know” basis.
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CONFIDENTIALITY STATEMENT
STUDENT EMPLOYEE
I, ____________________________________, understand that by the virtue of my
employment with Tarleton State University, I may have access to records which contain
individually identifiable information, the disclosure of which is prohibited by the Family
Educational Rights and Privacy Act of 1974 (FERPA). This information is confidential and
may not be divulged to anyone except the person who owns the information, those faculty/
staff/administrators who have a “legitimate educational need to know,” and those individuals/
agencies (parents/guardians who sign/file the Certification of Dependency form, the National
Student Clearinghouse acting as an agent of Tarleton State University, scholarship agencies
or an embassy for example) who fulfill the requirements under FERPA. Confidential
information includes anything not defined as “directory information” by Tarleton State
University, as well as, directory information a student has put a hold on with the paper form.
I acknowledge that I fully understand that the intentional disclosure by me of this information
to any unauthorized person could subject me to criminal and civil penalties imposed by law.
I further acknowledge that such willful or unauthorized disclosure also violates the
institution’s policy and could constitute just cause for disciplinary action including
termination of my employment regardless of whether criminal or civil penalties are imposed.
I have read the above and agree to the requirements for confidentiality.
_______________________________
____________________________
Name of User (Please Print)
Signature of User
_______________________________
____________________________
UIN
Department
__________________________________________
Accepted By
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Date
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HR 203 (10/01)
The Texas A&M University System
Statement of Selective Service Registration Status
With few exceptions, you have the right to request, receive, review and correct
information about yourself collected using this form.
Under HB 558, enacted by the 76th Texas State Legislature, if
you are currently of the age and gender requiring registration
with Selective Service, but knowingly and willfully fail to do so,
you are ineligible for employment with an agency in any branch
of Texas state government. Any offer of employment is
contingent on your compliance with Selective Service law.
Exemptions
Almost all male U.S. citizens, and male aliens living in the U.S.,
who are 18 through 25 years of age, are required to register with
Selective Service. Some non- citizens are required to register
and others are not.
Selective Service Registration Card.
Privacy Act Statement
Because information on your registration status is
essential for determining whether you are in
compliance with Selective Service law, failure to
provide the information requested by this statement
will prevent any further consideration of you for
employment. This information is subject to verification
with the Selective Service System and may be
furnished to federal agencies for law enforcement or
other authorized use in implementing the law.
Non-citizens not required to register include men who are in the
U.S. on student or visitor visas, and men who are part of a
diplomatic or trade mission and their families. Almost all other
male non-citizens are required to register, including illegal aliens,
legal permanent residents, and refugees.
False Statement Notification
Non-Registrants
Should any question arise regarding your registration
or eligibility for an exemption, you may request an
official "status information" letter from the Selective
Service System by calling 1-847-688-6888. As an
alternative, you may send a written request to the
Selective Service System at P.O. Box 94638,
Palatine, IL 60094-4638.
If you are not registered as required, you are presently not
eligible to be hired and should register promptly at a United
States Post Office. A Certificate of Mailing may be obtained from
the Post Office at such time that you mail your registration and
may be used as proof of your application until you receive your
A false statement may be grounds for not hiring you,
or for dismissal, if you have already begun work.
Review
Certification of Registration Status
( )
I certify that I am a male age 18 through 25 and am properly registered with the Selective Service System.
( )
I certify that I am not currently of the age required to register with Selective Service.
( )
I certify that I have been determined by the Selective Service System to be exempt from the registration
provisions of Selective Service law.
( )
I certify that I have not reached my 18th birthday and understand I may be required by law to register at that time.
I understand that under HB 558, enacted by the 76th Texas Legislature, I must be registered with the Selective Service System according to
the requirements of federal law in order to be employed with an agency in any branch of Texas state government. I further certify that the
information provided on this form is true, complete and correct to the best of my knowledge. I understand that any false statements may void
my application for employment and that the information provided on this form will be used only for evaluation of eligibility for employment.
______________________________________________
__________________________
____________________
Name (please print)
Social Security Number or UIN
Date of Birth
______________________________________________
__________________________
Date
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The Texas A&M University System
Minor’s Employment Release *
With few exceptions, you have the right to request, receive, review and correct information about yourself collected using this form.
State of Texas,
County of
I/We,
and
Parent or legal guardian name (please print)
of
Parent or legal guardian name (please print)
, Texas, being the father and/or mother or
County name
legal guardian(s) and also having the legal custody of
Minor name (please print)
born on
do hereby give my/our full and unconditional consent for
Minor birth date
to accept employment and receive compensation
Minor name
from the Texas A&M University System. I/We hereby release and waive all liability accruing
because of his/her accepting employment while he/she is a minor and authorize any emergency
medical treatment as needed.
_____________________________________
_______________________________
Parent or legal guardian signature
Parent or legal guardian signature
__________________________________________
____________________________________
Witness (please print)
Witness signature
______________________
Signature date
For any person who may be younger than 19, age should be verified by a certificate of Age
from the Texas Workforce Commission, a Federal Certificate of Age from the U.S. Department
of Labor, or other documentation acceptable to the employing institution’s or agency’s
Human Resources Officer. A Minor’s Employment Release and age documentation must be
maintained on any employee younger than 18.
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Drug and Alcohol Abuse
Approved February 27, 1995 (MO 44-95)
Revised September 26, 1997 (MO 181-97)
Revised September 23, 1999 (MO 225-1999)
Revised January 22, 2009 (MO 029-2009)
Reviewed April 3, 2012
Next Scheduled Review: April 3, 2017
Policy Statement
The Texas A&M University System (system) strictly prohibits the unlawful manufacture,
distribution, possession or use of illicit drugs or alcohol on system property, and/or while
on official duty and/or as part of any system activities.
Reason for Policy
This policy is established to help members maintain a safe and healthy environment for
all students and employees, to ensure compliance with applicable law and to require the
adoptiAn and implementation of a program to help prevent the use of illicit drugs and alcohol abuse by students and employees.
Procedures and Responsibilities
1.
All members and member students and employees are expected to abide by state and federal laws pertaining to controlled substances, illicit drugs and the use of alcohol. Each
member will adopt a plan consistent with this policy that will include implementation of
an awareness and prevention program on the use of illicit drugs and the abuse of alcohol by students and employees.
2. Sanctions (consistent with local, state and federal law) will be imposed on students
and employees for the violation of this policy. Sanctions may include disciplinary actions up to and including expulsion, termination of employment and referral for prosecution.
3. This policy is in addition to any alcohol or drug abuse policy or policies relating to participation in intercollegiate athletics.
4. The chancellor is authorized to implement regulations to ensure full compliance with
applicable statutes and administrative rules or guidelines.
1 of 2
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Related Statutes, Policies, or Requirements
20 U.S.C. § 1011i, Drug and Alcohol A buse Prevention
41 U.S.C. Ch. 10 (§§ 701-707), Drug-Free Workplace Act of 1988
34 C.F.R. Pt. 86, Drug and Alcohol A buse Prevention
System Regulation 34.02.01, Drug and Alcohol Abuse and Rehabilitation Programs
Member Rule Requirements
A rule is not required to supplement this policy.
Contact Offices
Office of General Counsel (979) 4586120
System Human Resources Offices (979) 458-6169
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Drug and Alcohol Abuse and
Rehabilitation Programs
Approved July 14, 2000
Revised September 2, 2013
Next Scheduled Review: September 2, 2018
Regulation Statement
The Texas A&M University System (system) and each member is committed to a drug-free
environment and protecting the safety, health and well being of all employees and students.
Reason for Regulation
The use of illicit drugs and alcohol may have a detrimental impact on the system and each
member in achieving their missions. This regulation provides guidelines for implementation of a
drug and alcohol abuse awareness, prevention and intervention program for students and
employees in accordance with the Drug-Free Workplace Act of 1988, the Drug-Free Work Force
Rules for Department of Defense (DOD) Contractors, and the Drug-Free Schools and
Communities Act of 1989.
Procedures and Responsibilities
1. ADMINISTRATION
The Office of General Counsel (OGC) must be informed by the appropriate administrator of
possible violations of this regulation and the advice of an OGC attorney must be secured
before testing anyone due to reasonable suspicion of drug or alcohol use or abuse. Advice of
the OGC is not needed for required testing as described in Section 4, and the OGC may
waive the requirement to seek OGC’s advice for reasonable suspicion testing when a member
shows documented evidence of training for administrators and supervisors in alcohol and
drug awareness.
2. MEMBER RULE
The chief executive officer of each member shall establish a rule for the implementation of
System Policy 34.02, Drug and Alcohol Abuse, and this regulation. Requirements of the DrugFree Workplace Act of 1988, the Drug-Free Schools and Communities Act of 1989 and the
Drug-Free Work Force Rules for Department of Defense (DOD) Contractors and the
requirements of the Department of Transportation or other regulatory bodies and applicable state
laws must be included as applicable for students and employees.
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3. ALCOHOL AND DRUG-FREE AWARENESS AND PREVENTION PROGRAM
3.1 In accordance with the Drug-Free Schools and Communities Act of 1989, each member
shall develop and implement an alcohol and drug-free awareness and prevention program
(program) for students and employees. Programs must conform to system policies and
regulations as well as related state and federal laws.
3.2 Annually, each member must notify, in writing, each employee and each student of:
(a) the standards of conduct that prohibit the unlawful manufacture, distribution,
dispensation, use and possession of illicit drugs and alcohol by students and employees on
system property or as part of any system activity;
(b) a description of the applicable legal sanctions under local, state or federal law for the
unlawful manufacture, distribution, dispensation, use or possession of illicit drugs or alcohol;
(c) a description of the health risks associated with the use of illicit drugs and alcohol;
(d) a description of drug or alcohol counseling, treatment, rehabilitation, re-entry or
employee assistance programs that are available to students and/or employees;
(e) a clear statement that the member, consistent with local, state or federal law, will
impose sanctions against a student or employee who violates the standards of conduct. The
statement must include a description of the possible sanctions; and
(f)
a description of the member’s program, including alternative support, education and
re-entry programs for students who are expelled as a result of violating standards required
by these minimum requirements.
3.3 As required by federal law, each member must conduct a biennial review of its program
and report:
(a) the effectiveness of the program;
(b) the consistency of sanction enforcement;
(c) the number of drug and alcohol-related violations and fatalities that occur on system
property or at system activities and reported to campus officials, and the number and type of
sanctions that are imposed by the member for such reported violations and fatalities on
system property or at system activities; and
(d) whether any changes to the program are needed and implement any such changes.
3.4 Each member shall, upon request, make available to the U.S. Secretary of Education or
designee, other applicable governmental agencies and the general public, all documents outlined
in Section 3.1, as well as the biennial review.
3.5 Members must certify the accessibility of a drug abuse prevention program for officers,
employees and students of the member, as required under 20 U.S.C.A. § 1094.
4. EMPLOYEE DRUG TESTING
4.1 Department of Defense
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4.2
4.1.1
In accordance with the Drug-Free Workplace Act of 1988 and the Drug-Free Work
Force Rules for Department of Defense (DOD) Contractors, government
contractors shall institute and maintain a program for achieving the objective of a
drug-free work force. The program shall include employee assistance programs
emphasizing education, counseling and rehabilitation; training to assist in identifying
and addressing illicit drug use; provisions for self-referrals as well as supervisory
referrals for treatment; and procedures for identifying illicit drug users, including a
random drug testing program for employees in sensitive positions.
4.1.2
As a condition of employment, employees on federal governmental grants or
contracts must abide by the required notification statement and must report any
criminal drug statute conviction for a violation occurring in the workplace or on
system business to their employer no later than five days after the conviction. The
employer, in turn, must notify the contracting federal agency within 10 days after
receiving notice from an employee or otherwise receiving actual notice of such
conviction and, within 30 days, must impose sanctions on the employee involved.
Sanctions may take the form of personnel actions against the employee, up to and
including termination, or requiring the employee to satisfactorily participate in an
approved drug abuse assistance or rehabilitation program.
4.1.3
Testing of an employee in a DOD-funded sensitive position will be undertaken
under the following circumstances: (1) when there is reasonable suspicion that an
employee uses illicit drugs, (2) when an employee has been involved in an accident
or unsafe practice, (3) as part of or as a follow-up to counseling or rehabilitation for
illicit drug use or (4) as part of a voluntary employee drug testing program.
Department of Transportation
Drug testing of employees required to have commercial driver’s licenses must comply with
Federal Highway Administration and Department of Transportation regulations and will be
conducted in the following situations:
(1) pre-employment, (2) post-accident,
(3) reasonable suspicion, (4) random and (5) return-to-duty and follow-up.
5. REASONABLE SUSPICION OF EMPLOYEE DRUG OR ALCOHOL ABUSE
5.1 If a supervisor reasonably suspects that use of a controlled substance or alcohol has
resulted in absenteeism, tardiness or impairment of work performance or is the cause of
workplace accidents, the supervisor shall immediately notify the appropriate department
head or designated administrator. Upon direction from the department head or designated
administrator, the supervisor or designated administrator shall discuss with the employee
the suspected alcohol or drug-related problem(s). The employee shall be advised of
available alcohol and drug counseling, rehabilitation or employee assistance programs, and
the terms of any applicable disciplinary sanctions. The employee may be required to
participate in an assistance program and be subject to discipline (up to and including
termination of employment) if he or she rejects participation in the program. All meetings
between the employee and the supervisor or designated administrator to address the
suspected alcohol or drug-related problem and/or its resolution shall be documented in a
memorandum to the record and filed in the employee's personnel file.
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5.2 If discussion and/or participation in available alcohol or drug counseling,
rehabilitation or the employee assistance program fails to resolve the suspected alcohol
or drug-related problem(s) or if the employee fails to meet the terms of any
applicable disciplinary sanctions, the employee may be subject to disciplinary action
up to and including termination.
5.3 Any disciplinary action will be governed by system policies on discipline and dismissal
and academic freedom, responsibility and tenure. A record of the action will be placed in
the employee's personnel file.
5.4 Testing of employees other than those occupying DOD-funded sensitive positions or
those required to have a commercial driver’s license may be undertaken only when
there is reasonable suspicion that the employee is under the influence of alcohol or
illicit drugs while on the job and the employee's job performance has been affected
by the use of alcohol or illicit drugs. The decision to test an employee in these
circumstances will be made by the appropriate chief executive officer or designee with
the advice of the OGC. The employee should be informed that a refusal to submit to
a test, combined with a reasonable suspicion of usage, may be sufficient basis for
termination.
6. TESTING PROCEDURES
The expense of the screening and any retest will be borne by the member. The screening will be
kept confidential, with the results being reported to the employee and the appropriate senior-level
administrator as soon as they are available. Any written documentation will be kept in the
employee’s confidential medical file.
6.1 Drug Testing
6.2
6.1.1
Prior to the administration of a drug test, the appropriate administrator or
supervisor must explain the drug testing procedures to the employee and arrange
for a member employee(s) to transport and accompany the employee to a hospital
or clinic for the taking of a specimen for screening purposes. If the member has
laboratory or medical facilities with personnel trained for such testing, those
facilities may be used if there are adequate chain-of-custody procedures
established for the samples, and precautions are taken to guarantee the integrity of
the testing against tampering or substitution.
6.1.2
Before the specimen is taken, the employee will be asked to sign a consent form
agreeing to the taking of a specimen for testing purposes. The signed form will
be required by the hospital or clinic. The employee may be asked to list any
medications being taken. The employee will have a reasonable opportunity to
rebut or explain a positive test result, including an independent retest of the
sample.
Alcohol Testing
Alcohol testing shall be conducted using an Evidential Breath Testing Device (EBT) that
has been approved by the National Highway Traffic Safety Administration.
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Related Statutes, Policies, or Requirements
20 U.S.C. § 1011i
20 U.S.C. § 1094
21 U.S.C.A. § 812, The Controlled Substances Act
41 U.S.C. §§ 701-707, The Drug-Free Workplace Act of 1988
34 C.F.R. 86 (Authority: 20 U.S.C. 1145g), The Drug-Free Schools and Communities Act of
1989
48 C.F.R. 252.223-7004, The Drug-Free Work Force Rules for Department of Defense (DOD)
Contractors
Texas Health and Safety Code, Chapter 481, Texas Controlled Substances Act
System Policy 34.02, Drug and Alcohol Abuse
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Definitions
Alcohol – any beverage containing more than one-half of one percent of alcohol by volume, which is capable
of use for beverage purposes, either alone or when diluted.
Alcohol abuse – the excessive use of alcohol in a manner that interferes with (1) physical or
psychological functioning; (2) social adaptation; (3) educational performance or (4) occupational
functioning.
Controlled substance – a substance listed in schedules I through V of the Controlled Substances Act (21
U.S.C.A. 812) or whose possession, sale or delivery results in criminal sanctions under the Texas Controlled
Substances Act (Texas Health and Safety Code, Chapter 481). In general, controlled substances include
all prescription drugs, as well as those substances for which there is no generally accepted medicinal use
(e.g., heroin, LSD, marijuana, etc.), and substances that possess a chemical structure similar to that of a
controlled substance (e.g., designer drugs). The term does not include alcohol.
Criminal drug statute – a criminal statute involving the manufacture, distribution, dispensation, use or
possession of any controlled substance.
Criminal drug statute conviction – a finding of guilt (including a plea of nolo contendere) or imposition of
sentence, or both, by any judicial body charged with the responsibility to determine violations of the state
or federal criminal drug statutes.
Drugs or other controlled substances – any substances capable of altering an individual's mood,
perception, pain level or judgment.
Employee in a sensitive position – an employee who has been granted access to classified information or
an employee in another position determined by appropriate administrative personnel to involve national
security, health or safety concerns, or functions requiring a high degree of trust and confidence.
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Rule 34.02.01.T1
Drug and Alcohol Abuse
Prevention
Effective:
Revised:
Next Scheduled Review:
June 5, 2002
September 18, 2012
September 18, 2017
Rule Statement
Tarleton State University desires to provide an educational and work environment free from drug
and alcohol abuse. Drug and alcohol abuse affects all aspects of American life: it threatens the
student’s educational development, the safety and security of the workplace and the confidence of
the community.
Reason for Rule
Tarleton is committed to providing its employees and students a safe, healthy and efficient
educational and work environment. This rule has been adopted to supplement existing system
policies and regulations. Implementation of this rule is subject to restrictions contained in local,
state, and federal laws.
Definitions
Alcohol: refers to any beverage containing more than one-half of one percent of alcohol by
volume, which is capable of use for beverage purposes, either alone or when diluted.
Alcohol Abuse: Excessive use of alcohol in a manner that interferes with: physical or
psychological functioning; social adaptation; educational performance; or occupational
functioning.
Controlled Substance: A substance listed in schedules I through V of section 202 of the
Controlled Substance Act (21 U.S.C.S. 812) or whose possession, sale or delivery results in
criminal sanctions under the Texas Controlled Substances Act (Texas Health and Safety Code,
Chapter 481). In general, controlled substances include all prescription drugs, as well as those
substances for which there is no generally accepted medicinal use (e.g., heroin, LSD, Marijuana,
etc.), and substances that possess a chemical structure similar to that of a controlled substance
(e.g., designer drugs). The term does not include alcohol.
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Illicit Drug or Chemical Substance: Any drug or chemical substance, the use, sale or possession of
which is illegal under any state or federal law, or one that is legally obtainable but has not been
legally obtained. The term includes prescribed drugs not legally obtained and prescribed drugs not
being used for prescribed purposes.
Impaired: Under the influence of an illicit drug or alcohol, such that the student or employee is
unable to perform his or her assigned tasks or poses a danger to him- or herself or others.
Possess: To be contained either on a student’s or employee’s person, or in a student’s or employee’s
motor vehicle, tools, briefcases, book bags, lockers or areas entrusted to the control of the student or
employee.
Prescribed Drug: Any substance prescribed for individual consumption by a licensed medical
practitioner. It includes only drugs that have been legally obtained and are being used for the purpose
for which they were prescribed or manufactured.
Sanctions: Include completion of an appropriate rehabilitation or assistance program, suspension or
expulsion from school, suspension or termination from employment, other disciplinary action, or
referral to authorities for prosecution. If an employee has been convicted of a criminal drug statute,
sanctions must be imposed within 30 days.
Workplace: Any office, building, classroom, or property (including parking lots) owned, leased, or
operated by Tarleton, or any other site at which an employee is to perform work for the employer.
Procedures and Responsibilities
1.
RISKS ASSOCIATED WITH ALCOHOL AND DRUG ABUSE
1.1.
Educational and Work Environment Risks
1.1.1. Inhibiting educational development and a student’s capacity to learn
1.1.2. Interfering with safe and efficient performance of work
1.1.3. Increased absenteeism
1.1.4. Poor health, safety, and productivity
1.1.5. Decreased productivity and attention to safety
1.1.6. Deterioration of public confidence and trust
1.2.
Health Risks
1.2.1. Alcohol abuse may lead to alcoholism, premature death through overdose and/
or complications involving the brain, heart, liver and other body organs.
1.2.2. Illicit drugs may result in drug addiction, death by overdose, death from
withdrawal, seizure, heart problems, infections (including HIV/AIDS), liver
disease and brain dysfunction.
1.2.3. Alcohol and drug use by a pregnant woman may cause additional health
complications in her unborn child.
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2.
3.
STANDARD OF CONDUCT
2.1.
Unlawful manufacture, distribution, dispensation, possession or use of illicit drugs or
alcohol by students or employee is prohibited at any time on any university property
or at any university activity. No employee may report for work, work or be present in
the workplace who is impaired by an illegal drug or by alcohol. No student may
attend classes or any university activity who is impaired by illegal drugs or alcohol.
Employees or students who are so impaired or who unlawfully possess, use,
manufacture, dispense, or distribute illicit drugs or alcohol in the workplace, on any
university property, or at any university activity are subject to the disciplinary
procedures of the university, which may include dismissal, expulsion, and/or referral
for prosecution.
2.2.
All members of the university community shall abide by state and federal laws
pertaining to controlled substances and illicit drugs.]
RESPONSIBILITY TO REPORT AND INVESTIGATE
3.1.
Employees are responsible for reporting arrests, charges or criminal convictions in
accordance with System Regulation 33.99.14, Criminal History Record Information
– Employees and Applicants. The employee may be placed on a leave with pay while
an investigation is completed. The Human Resources Department (HR) will initiate an
investigation in accordance with System Regulation 33.99.14. Sanctions may include,
but are not limited to, discipline, referral to a treatment program, or dismissal.
3.2.
Employees shall report to their supervisors, or to HR, any use of a prescribed or overthe-counter medication that could adversely affect job performance. Any such medical
information will be kept confidential and shared with appropriate personnel only on a
need-to-know basis. For those employees adversely affected by the medication during
the normal course of duty, the university will take appropriate action, such as placing
the employee on leave, in accordance with leave regulations and, when applicable, the
Americans with Disabilities Act.
3.3
Employees and students are responsible for reporting a reasonable suspicion of drug or
alcohol abuse by employees or students to their immediate supervisor, HR, Office of
Student Life Studies and Judicial Affairs, or to the University Police Department. A
reasonable suspicion is a fair or usual belief or opinion a person might form based on a
certain set of facts or circumstances. Individuals may have days when they exhibit
behavior not normally associated with an educational or work environment nor
characteristic of him or her. Unusual behavior during times of stress is not uncommon;
however, when unusual behavior is displayed on a gradually increasing scale
accompanied by general decline in work habits or classroom performance over a period
of time, it may indicate that professional help is needed.
3.3.1
Administrators or supervisors seeking advice on appropriate responses to possible
violations of alcohol or drug rules by employees should consult with HR.
3.3.2
Students found in violation of drug and alcohol abuse rules and regulations will be
subject to the disciplinary measures outlined in the Student Handbook, Student
Athlete Handbook, and to all pertinent local, state and federal statutes.
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3.3.2.1 Sanctions may include completion of an appropriate rehabilitation or assistance program,
expulsion from school or referral to authorities for prosecution.
4.
NOTIFICATION
4.1 Tarleton will provide notification of this rule to employees and students initially upon hire or firsttime registration, and annually thereafter.
5.
EDUCATION PROGRAM
5.1.
6.
A committee, appointed by the president, will develop and promote the university’s drug and
alcohol prevention and education program. The committee will biennially review the
education program in accordance with the Drug-free Schools and Communities Act to
determine its effectiveness. The report generated by this review will be provided to the
president and posted on the Tarleton website. The committee’s report will include
recommendations for program changes as needed.
TREATMENT AND REFERRAL RESOURCES
6.1.
An employee or student may be required to participate in and satisfactorily complete an
approved rehabilitation or assistance program. Tarleton has identified the following sources
available to employees and students. The Department of Human Resources, the Student
Counseling Center, and the Office of the Assistant Dean of Students are available to assist
employees and students in identifying services and assistance as well.
On Campus Resources:
Department of Human Resources 254-968-9128 Student Counseling Center: 254
-968-9710
Office of the Assistant Dean of Students: 254-968-9080
Related Statutes, Policies, or Requirements
Drug-Free Schools and Campuses Regulations (EDGAR) Part 86 System
Policy 34.02 Drug and Alcohol Abuse
System Regulation 34.02.01 Drug and Alcohol Abuse and Rehabilitation Programs
Tarleton State University Student Handbook Tarleton
State University Student Athlete Handbook
Contact Office
Human Resource Department 254.968.9128
University Compliance 254.968.9415
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Prevention of Alcohol Abuse and Illicit Drug Use
Annual Awareness and Prevention Program Notice to Tarleton State University Employees
________________________________________________________________________
Alcohol abuse and illicit drug use disrupt the work and learning environment and create an unsafe and unhealthy
workplace. To protect its employees and students and fully serve the citizens of Texas, The Texas A&M University
System prohibits alcohol abuse and illicit drug use that could negatively impact its mission. This brochure, which is
distributed annually, serves as an awareness and prevention tool for Tarleton employees by providing basic
information about A&M System policy and regulations, legal sanctions and health risks related to alcohol abuse and
illicit drug use. Information about counseling, treatment and rehabilitation programs is included.
________________________________________________________________________
As an employee of The Texas A&M University System, you must abide by state and federal laws on controlled substances,
illicit drugs and use of alcohol. In addition, you must comply with A&M System policy, which states:
The Texas A&M University System (system)
strictly prohibits the unlawful manufacture,
distribution, possession or use of illicit drugs on
system property, and/or while on official duty
and/or as part of any system activities.
Definitions
Alcohol refers to any beverage that contains more
than one-half of one percent of alcohol by volume,
which is capable of use for beverage purposes,
either alone or when diluted.
Alcohol abuse is the excessive use of alcohol in a
manner that interferes with:
physical or psychological functioning,
social adaptation,
educational performance, or
occupational functioning.
Controlled substances include all prescription drugs, as
well as those substances for which there is no generally
accepted medicinal use (e.g., heroin, LSD and
marijuana, etc.), and that possess a chemical structure
similar to that of a controlled substance (e.g., designer
drugs).
Illicit drugs are:
any drugs or chemical substances, the use,
sale or possession of which is illegal under any
state or federal law, or
ones that can be legally obtained but have not
been obtained legally.
The term includes prescribed drugs not legally obtained
and prescribed drugs not being used for prescribed
purposes.
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Health Risks
Alcohol abuse can lead to alcoholism, premature death
through overdose, and complications involving the
brain, heart, liver and many other body organs.
The abuse of illicit drugs can result in other health
problems such as drug addiction, death by overdose,
death from withdrawal, seizure, heart problems,
infections (including HIV/AIDS), liver disease and
brain dysfunction. Additional effects include
occupational, social and family problems as well as a
reduction in motivation. Drug use by a pregnant
woman may cause additional health complications in
her unborn child.
A&M System Sanctions
The A&M System’s drug and alcohol abuse policy
and regulation are included in the System Orientation
course reviewed by new employees as part of their
orientation. The policy and regulation are posted
online at http://policies.tamus.edu/34-02.pdfand
http://policies.tamus.edu/34-02-01.pdf
If your work-related performance causes suspicion of
use of alcohol or a controlled substance, you may be
tested under the provisions of the A&M System
regulation related to testing and chemical screening.
You also may be tested if necessary to comply with
Department of Defense, Department of
Transportation or other regulations that cover certain
employees. Refusal to submit to a test may be the
basis for employment termination.
37
Off-duty use of alcohol, drugs or other controlled
substances will not be tolerated if the use results in
absenteeism, tardiness or impairment of work
performance or is the cause of workplace accidents.
Should this occur, you may be referred to an
assistance program and subject to discipline, up to
and including employment termination.
Operating a motor vehicle, aircraft or watercraft in a
public place while intoxicated
First Offense: Class B Misdemeanor with a minimum
confinement of 72 hours
Second Offense: Class A Misdemeanor
Subsequent Offenses: Third-Degree
Felonies
Any disciplinary action will be governed by A&M
System policies and regulations on discipline and
dismissal and academic freedom, responsibility and
tenure. A record of the action will be placed in your
personnel file. Infractions of local, state or federal
law will be reported to the appropriate law
enforcement agency.
Causing serious bodily injury to another by accident or
mistake while operating a motor vehicle, including
motor aircraft or watercraft, in a public place while
intoxicated (Third-Degree Felony)
Legal Sanctions
Legal sanctions can include:
Misdemeanor Jail Time and/
or Fine Class A Up to one
year; Up to $4,000 Class B Up
to 180 days; Up to $2,000
Class C No confinement; Up to
$500
Felony Imprisonment and/or Fine
First Degree 5 to 99 years or life; Up to
$10,000 Second Degree 2 to 20 years;
Up to $10,000 Third Degree 2 to 10
years; Up to $10,000
State Felony 180 days to 2 years; Up to $10,000
These sanctions may be imposed for many illegal
actions including:
Purchasing or making available an alcoholic beverage
to a person younger than 21 (Class A Misdemeanor)
Selling an alcoholic beverage to a person younger than
21 (Class A Misdemeanor)
Appearing in a public place while intoxicated to the
degree that you might endanger yourself or another
person (Class C Misdemeanor)
Possessing an open container of an alcoholic beverage
inside a motor vehicle on a public roadway
(Class C Misdemeanor)
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Causing the death of another by accident or mistake
while operating a motor vehicle, including motor aircraft
or watercraft, in a public place while intoxicated
(Second-Degree Felony)
Possession, manufacture and/or delivery of a controlled
substance (A violation of state and federal laws.
Penalties vary according to the type of substance,
amount in possession, manufactured and/or delivered,
and the number and type of previous violations. In
addition, penalties increase if controlled substances
are delivered within 1,000 feet of any premises owned,
rented or leased by an institution of higher education.)
Community Resources
If you have an alcohol or other drug abuse problem, you
may want to seek information or help from one of the
following community resources.
Employee Assistance Program
Deer Oaks EAP Services
24/7 Confidential Helpline: (800) 993-7650
Website: www.deeroaks.com (user/psw =
Tarleton) E-mail: [email protected]
STAR Council on Substance Abuse
Education, Assessment and Referral
Services 239 S. Virginia Ave
Stephenville, Texas 76401
(254) 965-5515
Summer Sky, Incorporated
Substance Abuse Treatment
Facility 110 N McCart Ave
Stephenville, Texas 76401
(254) 968-2907 (24 hr. crisis line)
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Alcoholics Anonymous
Stephenville Group of Alcoholics
Anonymous 611 S. Graham
Stephenville, Texas 76401
(254) 965-4727
Email: [email protected]
Website: http://stephenvilleaa.webs.com/
Other Resources
Other community services include therapists,
counselors, treatment centers and support groups. For
assistance in identifying an appropriate service, contact
the Department of Student Life, Alcohol and Drug
Education Programs.
The Texas Department of State Health Services’
Mental Health and Substance Abuse Services
agency, http://www.dshs.state.tx.us/mhsa, can
provide information on laws and services regarding
drug and alcohol abuse.
For More Information Employee Services
Main Campus | Admin Annex I | Room 105
(254) 968-9128
Community hospitals provide emergency care for drug
or alcohol medical problems. Most health plans cover
treatment of alcohol abuse and other illicit drug use
problems. You should contact the Human Resources
office or call your health plan member services
number for information about plan coverage.
This brochure is a summary of System Policy 34.02, Drug and Alcohol Abuse and System Regulation
34.02.01, Drug and Alcohol Abuse and Rehabilitation Programs. It does not include the complete policy,
regulation or detailed information on applicable local, state or federal law. In case of any discrepancy
between this brochure and policy, regulation or law, the policy, regulation or law will govern. Detailed
information on health risks is available from accredited health care providers and more information on
community resources is available from the resources listed in this brochure.
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HIV/AIDS and the Workplace
You may be wondering what HIV and AIDS could have to do with your job and workplace. Well, it depends on the type of work you
do. Some people, like health care workers, have to deal with HIV and AIDS every day. Most of us, though, don’t need to give much
thought to HIV or AIDS when it comes to our jobs. And that makes a lot of sense, because HIV is not spread through the type of
casual day-to-day contact that most of us have with other people in our jobs. On the other hand, ikt does make sense to be familiar
with HIV and AIDS for our own personal health, as well as with the situations that might come up at work that do involve HIV and
AIDS.
What you should know about HIV, AIDS and the workplace:
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

HIV is the virus that causes AIDS, a disease that destroys a person’s immune system.
There are only a few ways that a person can be infected with HIV—most of which don’t involve work related
situations.
It is easy to protect yourself from being infected with HIV, both in your personal life and in workplace settings.
Some general information about HIV/AIDS:
Acquired Immune Deficiency Syndrome (AIDS) is the final stage of an infection caused by the Human Immunodeficiency Virus
(HIV). HIV attacks the body’s immune system, hurting the body’s ability to fight off diseases and other infections.
There is no cure for HIV infection or AIDS. Ther e ar e also no clear symptoms of HIV infection, although some people may
have flu-like symptoms for a few days after they are infected with HIV. But, even if an infected person has no symptoms, feels and
looks healthy, he or she can still pass on the virus to others.
HIV is spread from person to person in the following body fluids:


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blood
Semen
Vaginal secretions
Breast milk
HIV is NOT spread through the environment; it is a very fragile blood-borne virus. HIV-infected persons do not pose a threat to coworkers or clients during casual, day-to-day activities and contacts.
You CANNOT be infected with HIV through:

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handshakes
hugs or casual touching
close working conditions
telephones, office equipment, or furniture
sinks, toilets, or showers
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dishes, utensils, or food
Sneezing or coughing
air
water
insects
There are only a few ways for a person to come in contact with HIV:

by having sex, either anal, oral, or vaginal, without the use of a condom;

By sharing needles, syringes, and other instruments that break the skin, such as tattoo and/or ear/body piercing needles;

From an HIV-infected mother to her baby during pregnancy, birth, or breastfeeding; and

By coming in contact with HIV-infected blood either through an open wound or through a blood transfusion. Risks from
transfusions, however, are now very low because of blood screening, which started in 1985.
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HIV/AIDS and the Workplace
How HIV/AIDS affects you in your workplace:
As you can see from the information on the last page, most of the behaviors that pass HIV from one person to another do not occur
in the workplace. The only way that most people in the average workplace could be exposed to HIV would be if they had an open
wound and someone else’s infected blood entered their body through that broken skin.
How to avoid HIV infection in the workplace:



keep broken skin covered with a clean, dry bandage;
Avoid direct contact with blood spills;
Wear gloves to clean spills that contain visible blood; and clean blood spills with an appropriate disinfectant or 1:10
solution of freshly missed household bleach and water. After cleanup, wash hands thoroughly with soap and running
water.
Ways to reduce your risk for HIV infection in your personal life:
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
Do not have sex (abstain)
Delay having sex until you are in a faithful relationship with one person who you know does not have HIV.
If you choose not to abstain from sex or limit sex to one faithful, uninfected partner, then always use a latex condom every time
you have sex (oral, anal, or vaginal). If used correctly and every time you have sex, latex condoms can provide protection
against HIV and other sexually transmitted diseases (STDs).
If you have a drug habit, do not share needles or syringes. If you can’t stop sharing needles/syringes, clean them with bleach and
then rinse them with water between every use. Also, do not share any other type of needles, such as tattoo and ear/body piercing
needles.
The best thing for your health is to stop using drugs. If you need help to stop using, call the National Drug Abuse Hotline at 1800-662-4357.
If you work with someone who has HIV and/or AIDS:
If you have a cold, flu or other virus, remember that people with HIV or AIDS do not have a healthy immune system. They are more
likely to become ill from a virus that a healthy person’s body could easily fight. Remember too, that people with HIV or AIDS are
just like anyone else living with a disease: they need caring, support, and understanding.
For HIV/STD testing locations in Texas call: 2-1-1
For other HIV/STD questions, call:
1 (800) CDC-INFO (English/Espanol)
DSHS TB/HIV/STD Unit
1 (888) 232-6348 (TTY)
DSHS Stock E4-148
Revised 10/2007
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HAZARDOUS CHEMICALS
Hazardous chemicals are any products or materials that
present any physical or health hazards when used,
unless they are exempted
used hazardous chemicals are fuels,
cleaning products, solvents, many types of oils,
compressed gases, many types of paints, pesticides,
herbicides, refrigerants, laboratory
WORKPLACE CHEMICAL LIST
Employers must develop a list of hazardous chemicals
used or stored in the workplace in excessof55gallonsor
500 pounds. This list shall be updated by the employer as
necessary, but at least annually, and be made readily
available for
EMPLOYEE EDUCATION PROGRAM
employees
before the employees work in a work
employees shall receive
training from the employer on the hazards of the chemicals
and on
from
those hazards. This training shall be repeated as
needed, but at least whenever new
SAFETY DATA SHEETS
Employees who may be exposed to hazardous
current
Safety Data Sheets (SDSs) or Material Safety Data
Sheets (MSDSs) if an SDS is not available yet, which
detail physical and health
chemicals.
LABELS
Employees shall not be required to work with
EMPLOYEE RIGHTS
Employees have rights to:


Employees may not be discharged or
discriminated against in any manner for the
exercise of any rights provided by this Act. A waiver
of employee rights is void; an employer’s request for
such a waiver is a violation of the Act. Employees may
file complaints with the Texas Department of State
Health Services at the
EMPLOYERS MAY BE SUBJECT TO ADMINISTRATIVE PENALTIES AND CIVIL OR CRIMINAL FINES RANGING
FROM $50 TO $100,000 FOR EACH VIOLATION OF THIS ACT
[email protected]
Worker Right-To-Know Program
Publication # E23-14173
Revised 03/2014
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The Texas A&M University System
Overview of Voluntary Supplemental Retirement Savings Programs
The 403(b) Tax-Deferred Account Program and the 457(b) Texa$aver Deferred Compensation Plan
Regardless of the mandatory retirement program you participate in (TRS or ORP), you can choose to save additional
money for retirement on a tax-deferred basis through the Tax-Deferred Account (TDA) Program and/or Texa$aver
Deferred Compensation Plan (DCP). All Texas A&M University System employees are eligible to participate in one
or both of these voluntary supplemental pre-tax savings programs at any time.
The TDA and DCP programs allow you to save money for retirement and postpone paying federal income tax on your
savings and investment earnings until you begin receiving the money. This will generally be after retirement, when your
income may be less and your tax bracket is likely to be lower. While employed, you may make financial hardship
withdrawals, though the plans’ definitions of a hardship differ. Upon termination of employment or retirement, you can
rollover your TDA and DCP accounts to another retirement plan (including an IRA) if you meet the requirements for a
rollover distribution.
You decide how much you want to save, from a $25 minimum monthly contribution for the TDA and a
$20 minimum monthly contribution for the DCP to the maximum allowed by federal law. Contributions are processed
through convenient payroll deduction. You can change the amount you save once each month. You may also choose to
defer part or all of a lump sum payment of annual leave upon termination of employment or retirement. However, you
must enroll in the DCP or TDA prior to your final day of employment in order to defer your annual leave lump sum
payment. Under the TDA Program, you must choose an investment vendor from the A&M System list of active
vendors. Under the DCP, you choose investment options from those companies authorized by the State of Texas. You
are responsible for choosing investment vendors and investment options and for any gains or losses on your account.
There are no employer matching contributions under either plan.
TAX-DEFERRED ACCOUNT PROGRAM
Enrollment
The Tax-Deferred Account Program is subject to Internal Revenue Code section 403(b), which allows you to
defer a portion of your current pre-tax or post-tax (Roth) income until retirement.
When you enroll in a TDA, you agree to have a specific amount or percentage of gross pay deducted from each
paycheck and sent to the vendor you choose from the A&M System list of active vendors, available on the Retirement
Programs web site at http://www.tamus.edu/business/benefits administration/retirement-programs/orptda-approvedvendors/ You may enroll in a TDA at any time and invest with up to two active vendors simultaneously. To enroll, you
complete a TDA Salary Reduction Agreement (SRA) and turn it in to your Human Resources or Payroll Office, along
with a copy of your completed vendor application. The TDA form is available from your Human Resources Office or
online at http://www.tamus.edu/business/benefits-administration/booklets-brochures-forms/retirement-forms/
Your TDA contribution will be deducted from your pay during or after the effective month you state on the SRA form,
depending on when your Human Resources or Payroll office receives your form. For example, if you are paid monthly
and turn in a SRA form stating an effective month of January before the payroll runs in January, the first deduction will
be made from the paycheck you receive at the beginning of February. If you are paid biweekly and turn in a SRA form
stating an effective month of January on or before the payroll first runs in January, the first TDA deduction will be
made from your paycheck that covers the first pay period that begins on or after January 1. The initial deduction for
biweekly employees will depend on the payroll schedule during the month in which the TDA enrollment is effective.
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IMPORTANT: If your TDA deduction amount is greater than your net pay for any pay period, no TDA deduction
will be taken.
Distribution Options
Because the purpose of a TDA is to provide retirement income, you may begin receiving distributions from your
account without penalty any time after you reach age 59½. You must pay federal income tax on your TDA savings
when you receive payments unless you have a Roth TDA. Because Roth TDA contributions are made after taxes, your
distributions upon retirement are tax-free. Federal law requires that you begin receiving payments by age 70½, unless
you are still employed. You choose how your benefit will be paid from the payment options offered by your
investment vendor(s). Your beneficiary will receive your account balance if you die before payment begins or will
receive any survivor benefits you choose if you die after you begin receiving payments.
Under the TDA Program, if you withdraw money before age 59½, you generally must pay a 10% penalty tax in the
year in which the money is withdrawn unless you withdraw because you become disabled and unable to work, you
die, you leave A&M System employment after age 55, or elect an annuity payout upon termination or retirement at
any age.
While you are employed with the A&M System, you may withdraw money from your TDA account only for one of the
above reasons unless you have a financial hardship as defined by federal law. This includes major unreimbursed
medical expenses, college costs for immediate family members, purchase of your primary residence or payments to
prevent eviction from or foreclosure on your primary residence. If you receive a financial hardship withdrawal, federal
law requires that contributions to the plan be suspended for six months. Some investment vendors allow you to take a
loan from your TDA account, some do not. Contact your TDA vendor to determine loan availability.
If you leave A&M System employment before retirement, you may leave your account invested, but you may make
no further contributions. You may also choose to withdraw your funds and pay any taxes due (including the penalty
tax in most cases) or roll your account balance into a similar plan at a new employer or an individual retirement
account.
Additional Resources
•
System Regulation 31.02.10 Tax-Deferred Account Program (tamus.edu/offices/policy/31- 02-10.pdf)
For additional information, review the following documents on the Benefits Administration web site (http://
www.tamus.edu/business/benefits-administration/retirement-programs/):
Retirement Programs Booklet Selecting a
TDA Vendor TDA Vendors List
TDA Fee Summary
TDA Annuity Product Summary
Maximum Contribution Limits TDA and Texa$aver DCP Comparison TDA and
Texa$aver DCP
TDAs: An Investment in Your Future
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TEXA$AVER DEFERRED COMPENSATION PLAN
Enrollment
The Texa$aver Deferred Compensation Plan is subject to Internal Revenue Code section 457(b), which allows you
to defer a portion of your current pre-tax income until retirement. The DCP is managed by the Employees
Retirement System of Texas, and Great West is the third-party administrator who can answer any questions you have
about the program. To enroll in the Texa$aver Deferred Compensation Plan, visit the web site at
www.texasaver.com, click on “457 Plan” for information about the plan and how to enroll. Next, download
enrollment form, enroll online or call at (800) 634-5091 to visit with a customer service representative who will
assist you in enrolling in the Texa$aver Program. You must identify yourself as an A&M System employee and be
prepared to provide the representative with the following information: name, Social Security number, address, date
of birth, date of hire, phone number, agency name, deferral amount and investment elections.
Deferral instructions received by Great West by 3 p.m. Central Time (CT) on the last business day of the month will
be effective the following month.
In the following example, the initial DCP deferral for an employee paid monthly is deducted in a new tax year,
although the effective enrollment date is December 1 of the previous year. The initial deduction for biweekly
employees will depend on the payroll schedule during the month in which the DCP enrollment is effective.
Enrollment period:
Effective date:
Before 3 p.m. CT on last business day of November
December 1
Initial deduction: January 1 pay voucher (December earnings but included in new tax year)
IMPORTANT: If your DCP deduction amount is greater than your net pay for any pay period, no DCP deduction will
be taken.
Distribution Options
Although the purpose of a DCP is to provide retirement income, you may begin receiving distributions from your
account when you leave state employment. You must pay federal income tax on your DCP savings when you receive
payments. Federal law requires that you begin receiving payments by age 70½, unless you are still employed. You
choose how your benefit will be paid from the payment options. Your beneficiary will receive your account balance if
you die before payment begins or will receive any survivor benefits you choose if you die after you begin receiving
payments.
While you are employed with the A&M System, two types of withdrawals are available through the DCP: financial
hardship and de minimus. The financial hardship withdrawals can be taken from your account to help cover the costs of
an unforeseeable emergency. The amount withdrawn cannot exceed the amount needed to satisfy the emergency. If you
receive a financial hardship withdrawal, your contributions to the DCP will be suspended for six months. De minimis
withdrawals can be taken from your account if you have a balance of $5,000 or less and you have not made contributions
for two years or longer. Hardship withdrawals are not subject to a penalty tax. However, the financial hardship and de
minimus withdrawals will be taxed as regular income in the year in which the money is received.
You may borrow funds from your Texa$aver Deferred Compensation Plan (DCP) account for a general loan (12-60
months) or a residential loan (61-180 months). Great West will process your request for loans and answer questions.
Unlike hardship withdrawals, contributions are not suspended for six months when you borrow funds from your DCP.
Amounts borrowed through the DCP loan program are not taxable unless you fail to repay the loan. Contact Great West
at (800) 634-5091 if you have questions regarding the loan process.
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If you leave A&M System employment before retirement, you may leave your account invested, but you may make
no further contributions. Or, you may withdraw your funds and pay regular income taxes (with no penalty tax) or roll
your account balance into a similar plan at a new employer or an individual retirement account.
Additional Resources
•
System Regulation 31.02.11 Deferred Compensation Program
For additional information, review the following documents on the Benefits Administration web site (http://
www.tamus.edu/business/benefits-administration/retirement-programs/):
Maximum Contribution Limits for TDA and Texa$aver DCP Comparison TDA and
Texa$aver DCP
Additional information about the Texa$aver Program is available online at texasaver.com click on “457 Plan”. Links
are provided for various features of the Texa$aver DCP.
Participation in the 403(b) Tax-Deferred Account Program or 457(b) Texa$aver Deferred Compensation Plan
entails certain responsibilities for the participant, including selection and monitoring of the vendor and individual
investments. The Texas A&M University System has no fiduciary responsibilities for the financial stability of the
vendor or the market value of individual investments chosen by the participant. Each employee bears the risk of
the performance of the product(s) of his/her choosing under these voluntary retirement programs, and The Texas
A&M University System is not liable for any tax consequences occurring under these retirement programs.
The contents of this document are intended for informational purposes only and should not be construed as tax or
legal advice, which can be rendered only when related to specific fact situations. In all cases, you should consult your
attorney or tax adviser if you have questions about your individual situation.
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