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ANNUAL CONFIDENTIALITY/PRIVACY STATEMENT
                                                                      FOR
                                                  CLIENTS/CUSTOMERS/STAFF/VENDORS/VISITORS/
                                                       BOARD OF DIRECTORS/VOLUNTEERS
                                                              Revised October 2005



In your involvement with Friendship Industries, you may be given access to Documents or become aware
of information that may be confidential and/or legally privileged or you may be shown Products, Samples,
etc. that are confidential or proprietary in their nature.

It is the policy of Friendship Industries, Inc. that all recipients of such confidential information (i.e.,
directors, employees, staff, interns, volunteers, vendors and other outside affiliates) shall respect and
preserve the privacy, confidentiality and security of confidential and proprietary information.

Furthermore, the clients of Friendship Industries (the persons with disabilities who we serve) are
guaranteed the right to have their identity, personal information and information about their disability kept
strictly confidential. Each client’s identity and personal information is not to be discussed with anyone
outside of the organization and should be discussed only with staff and even then with consideration to
the client’s right to confidentiality. This is both the policy of Friendship Industries and the law.

Violations of this statement include, but are not limited to:

      • accessing confidential or proprietary information that is not within the scope of your duties;
      • misusing, disclosing without proper authorization, or altering confidential or proprietary information;
      • disclosing to another person your Friendship Industries, Inc. website sign-on code and/or password
           for accessing electronic confidential or proprietary information or for physical access to restricted
           areas;
      • using another person’s alarm sign-on code and/or password for accessing confidential or proprietary
           information or for physical access to restricted areas;
      • intentional or negligent mishandling or destruction of confidential information or property;
      • leaving a secured website application unattended while signed on; or
      • attempting to access a secured application, restricted area or property without proper authorization
           or for purposes other than official Friendship Industries, Inc. business.

Violation of this statement may constitute grounds for corrective action up to and including termination of
employment or volunteer status, removal from the Board of Directors, loss of privileges or contractual or
affiliation rights in accordance with applicable Friendship Industries, Inc. procedures.

Unauthorized use or release of confidential or proprietary information may also subject the violator to
personal, civil, and/or criminal liability and legal penalties.

I have read and agree to comply with the terms of the above statement in accordance with my
relationship with Friendship Industries, Inc.

Name:________________________________________________________________________
(please print)

                 SS#: _______________________________________

Signature/Date _______________________________ / _______________

1 – Office Copy              2 – Signer Copy

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Confidentiality Statement

  • 1. ANNUAL CONFIDENTIALITY/PRIVACY STATEMENT FOR CLIENTS/CUSTOMERS/STAFF/VENDORS/VISITORS/ BOARD OF DIRECTORS/VOLUNTEERS Revised October 2005 In your involvement with Friendship Industries, you may be given access to Documents or become aware of information that may be confidential and/or legally privileged or you may be shown Products, Samples, etc. that are confidential or proprietary in their nature. It is the policy of Friendship Industries, Inc. that all recipients of such confidential information (i.e., directors, employees, staff, interns, volunteers, vendors and other outside affiliates) shall respect and preserve the privacy, confidentiality and security of confidential and proprietary information. Furthermore, the clients of Friendship Industries (the persons with disabilities who we serve) are guaranteed the right to have their identity, personal information and information about their disability kept strictly confidential. Each client’s identity and personal information is not to be discussed with anyone outside of the organization and should be discussed only with staff and even then with consideration to the client’s right to confidentiality. This is both the policy of Friendship Industries and the law. Violations of this statement include, but are not limited to: • accessing confidential or proprietary information that is not within the scope of your duties; • misusing, disclosing without proper authorization, or altering confidential or proprietary information; • disclosing to another person your Friendship Industries, Inc. website sign-on code and/or password for accessing electronic confidential or proprietary information or for physical access to restricted areas; • using another person’s alarm sign-on code and/or password for accessing confidential or proprietary information or for physical access to restricted areas; • intentional or negligent mishandling or destruction of confidential information or property; • leaving a secured website application unattended while signed on; or • attempting to access a secured application, restricted area or property without proper authorization or for purposes other than official Friendship Industries, Inc. business. Violation of this statement may constitute grounds for corrective action up to and including termination of employment or volunteer status, removal from the Board of Directors, loss of privileges or contractual or affiliation rights in accordance with applicable Friendship Industries, Inc. procedures. Unauthorized use or release of confidential or proprietary information may also subject the violator to personal, civil, and/or criminal liability and legal penalties. I have read and agree to comply with the terms of the above statement in accordance with my relationship with Friendship Industries, Inc. Name:________________________________________________________________________ (please print) SS#: _______________________________________ Signature/Date _______________________________ / _______________ 1 – Office Copy 2 – Signer Copy