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By submitting this
application, I signify that I understand the information in this application will
be used for the purpose of determining my qualifications for employment. I give
permission for the company to order MVR, DAC Reports, and do Background Check.
(Required) DISCLAIMER I certify that I personally completed this
application and that all of the information is true and correct.
I
hereby authorize, without liability, any person or organization, including but not
limited to any educational institution, training facility or any institution,
whose name I have given as a reference, or by whom I have been previously employed
to furnish this company any information they may have concerning my character,
habits, ability, financial responsibility, job performance, reasons for leaving
employment, and all information concerning my employment or training to give such
information to other companies and carriers requesting such information.
Furthermore, there may be entities that the Company does business with that may
request investigative reports or consumer reports which apply to my background. In
this case, these reports would apply to my assignment to projects related to the
Customer, permission to be on the Customers' premises and to handle its products
and other security concerns of the customer. I hereby release all such persons and
organizations from any claims for damages of any kind, which may occur to me by
reasons of furnishing such information. I hereby authorize any law enforcement
agency or court of record to furnish this company information concerning Motor
Vehicle Record, or any felony or misdemeanor of which I have been convicted.
Under the authority granted me by 49 CFR Parts 40 and 382, I hereby
authorize and require my previous and/or current employers specifically listed as
well as any other person or company provided by me in writing or by verbal
interview by whom I was employed or to whom I applied for employment in the two
year period preceding the date of this application to release the date, type of
test and result of all drug and alcohol test taken by me, including the date and
type of test for any refusals by me to take a drug or alcohol test, to the
individual(s) assigned to process my application at this company. If I tested
positive on any controlled substance test, had an alcohol test with a
concentration of 0.04 or greater, or refused to take any drug or alcohol test, I
also authorize the release of all information concerning my referral to a
Substance Abuse Professional (SAP) including all records pertaining to my
evaluation and treatment (if required by SAP). I authorize this release by
whatever means is most expedient and agree to hold harmless any past employer or
any person or company I applied with as well as their employees, agents, or
representatives from all liability or damage that may arise from the release of
the information specifically authorized here.
I have completed this
application of my own free will and hold matstrucking.com, Mats Trucking Inc, it's
owners, affiliates, copyright holders and other associated individuals harmless of
all liability for providing this application for my use. I also understand that a
written and signed version of this release will be required upon successful
completion of a phone interview. I also understand I will be required to fill in a
long form application for records purposes at orientation if I am selected for
this position.
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