I voluntarily agree to waive overtime pay for working on sixth (6th) day in a workweek. I understand that notwithstanding this waiver, I am entitled to overtime pay after eight (8) hours in any one day and after forty (40) hours in any one week.



This agreement may be rescinded upon two (2) weeks notice.



Date Submitted: ________________________________________



Pharmacist's Name: ____________________________________



Pharmacist signature: ____________________________________



Union signature: ________________________________________



Company signature: _____________________________________



After signing and obtaining the signature of a company representative, please submit this form to your Union Representative for consideration.






Pharmacists - please retain a copy for your records.