To be Read and Signed by Driver Applicant
This certifies that this Driver Qualification Form was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge. 49 CFR 391.21(b)(12)..
I understand and agree that drug and alcohol testing will be performed in accordance with 49 CFR part 40 and any additional testing as required by the Company. Failure of any test, or a failure to submit to a test as requested, will be considered grounds for nonconsideration.
I also understand and agree that failure of any test required by 49 CFR part 40 will be released to USIS (or any equivalent service as determined or utilized by the Company). I authorize the release of any controlled substance and/or alcohol test result in response to any inquiry regarding my work history with May Trucking Company.
I understand that it is May Trucking Company's policy to maintain practices, which prevent discrimination against my person on the basis of race, creed, sex, religion, national origin or any other protected classification.
I understand and agree that this Driver Qualification Form and other related documents will be retained for no longer than 30 days from the date of submission. At the conclusion of that time, if I have not been qualified by the Company and I still wish to be considered for qualification, it will be necessary for me to complete another Driver Qualification Form.
I understand and agree that any misrepresentation of information shall be considered an act of dishonesty and grounds for nonconsideration.
I understand and agree that this form does not obligate May Trucking Company in any way. I understand that the information in this qualification form will be used for qualification purposes and that prior employers may be contacted for the purpose of investigation as required by 49 CFR 391.23.
I understand and agree that this form must be signed by me in order to commence with the qualification process with May Trucking Company. Failure to sign this form will result in nonconsideration for qualification. Facsimile and electronic signatures shall be considred original signatures.