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COLUMBIA COUNTY BOARD OF COMMISSIONERS APPROVED: July 21, 2009 AMENDED: August 16, 2016 September 21, 2021 TOPIC: Outside Employment Policy Number 208.1 POLICY SECTION: Human Resources Page 3 of 3 Request for Approval of Outside Employment In accordance with Columbia County, Georgia Comprehensive Policy Manual, July 2009, Policy 208.1, Outside Employment, the following employee is submitting a request to perform outside employment. Requested By: Department: Prospective Employer: Job Title: Hours of Work/Days: I, have read and understand the Outside Employment Policy as written in the Columbia County Comprehensive Policy Manual, July 2009, Policy 208.1. I understand I will be required to submit a new Request for Outside Employment approval form annually, or if there are any changes in my Outside Employment hours of work/days or a change of Outside Employment employer. I understand that if my Outside Employment is approved and causes a conflict with my Columbia County Employment, I will discontinue the Outside Employment or resign my position from Columbia County. I understand that my Division Director may withdraw or disapprove a previously approved Outside Employment request at any time. I understand that no request is considered approved until the Division Director signs the form. Employee Date Approve Disapprove Department Manager Date Approve Disapprove Division Director Date Approve Disapprove Human Resources Director Date C: Employee Personnel File