Employee Referral Form

Do you know someone who would be a “perfect fit” for our team? Here’s your chance to bring a talented individual to the organization – and receive a generous referral bonus if they are hired! It’s even better than a win-win: we get a qualified associate, they get a job they will love...and you get the bonus. Imagine how great that would be!

EMPLOYEE REFERRAL PROGRAM EARN $0 OR MORE* Do you know someone who would be a “perfect fit” for our team? Here’s your chance to bring a talented individual to the organization – and receive a generous referral bonus if they are hired! It’s even better than a win-win: we get a qualified associate, they get a job they will love…and you get the bonus. Imagine how great that would be! DATE: EMPLOYEE NAME: REFERRAL CANDIDATE: POSITION APPLYING FOR: This referral form must be submitted prior to the first interview. *Here’s what you could earn: General Referrals FVP, SVP Positions VP Positions $0 $0 $0 Bonuses are as follows: • The referral bonus will be payable in two installments to the employee referring the hired candidate: • The first half is payable the first pay period after the new employee begins employment, the second half is payable after the new employee has been with the Company for six months. • All referral bonuses are taxable income at the higher supplemental tax rate. Employee Referral Program guidelines are as follows: • Referral forms must be complete and submitted with an attached resume. No other forms will be accepted. • Referred candidates must meet position qualifications. • 90 days employment with company is required to participate in the program. • Referrals of individuals who are presently or previously employed by the Company, actively interviewing, were previous applicants or third-party referrals will not be accepted, including interns returning for permanent employment. • If more than one employee submits the same referral, the earliest submitted is eligible for award. • Both the referring and referred employees must be employed with the Company at the time of payout to receive each bonus. If the referring or the referred employee resigns, retires or is discharged before the date of payout, the referring employee will not receive the bonus. • There is no limit on the number of referrals any employee may make. • Referral is only for the position listed; a new form is required for future/other positions. • Employees in Human Resources or with hiring responsibilities are not eligible for the Referral Program for positions filled under their hiring authority. • Interns and Temporary employees are not eligible for the Referral Program. Candidate information that is not submitted to Human Resources cannot be guaranteed for recognition. For job postings visit acme.com.

Employee Referral Form - Page 1 Employee Referral Form