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Acknowledgement of Receipt and Acceptance of Pregnant Workers Fairness Act

  1. ALL EMPLOYEES ARE REQUIRED TO ACKNOWLEDGE RECEIPT OF AND ACCEPTANCE OF THE PREGNANT WORKERS FAIRNESS ACT.

  2. YOUR INFORMATION

  3. ACKNOWLEDGEMENT OF RECEIPT OF THE PREGNANT WORKERS FAIRNESS ACT

  4. By typing your full name above you are acknowledging that you have received and read the Pregnant Workers Fairness Act Policy.

  5. SUBMIT YOUR ACKNOWLEDGEMENT AND RECEIPT

  6. Leave the box below checked and enter your desired email address to receive a copy of your form submission:

  7. Leave This Blank:

  8. This field is not part of the form submission.