MTRK Metropolitan Trucking, Inc. A Family Tradition DRIVER Application for Employment
Only complete this application if applying for a driver position If applying for another position ask for non-driver application

COMPANY POLICY
Our policy prohibits discrimination based on race, color, sex, age, religion, national origin, sexual preference or orientation, handicap(which can reasonably be accommodated), union affiliation, veteran or marital status, or any other basis which is prescribed by application federal or state law. NO QUESTION SHALL BE USED FOR DISCRIMINATORY PURPOSES. Instructions to Applicant: Please print answers to EVERY QUESTION. If the answer to any question is no, check the proper box or write No. DO NOT LEAVE QUESTIONS UNANSWERED. UNANSWERED QUESTIONS MAY DISQUALIFY AN APPLICANT FROM FURTHER CONSIDERATION.

Do you have a reliable means of getting to work?

Yes
No

Are you willing to work up to 14 hours per day?

Yes
No

Have you ever served in the US Military?

Yes
No

Can you perform the essential functions of the job without reasonable accommodations?

Yes
No

Have you ever been employed by MTRK or JNM Services or Metropolitan logistics or Transit management services Inc. of NJ?

Yes
No

Have you ever been disciplined by any of your employers during the past three years?

Yes
No

Do you have any relatives at MTRK

Yes
No

Are you a citizen of, or are you authorized to work, in the United States

Yes
No

Proof of citizenship or authorization will be required as a condition of hire.

READ CAREFULLY: List ALL Criminal convictions which have not been cleared from your record or sealed with the Commissioner of Probation. (A conviction record will not necessarily bar an applicant from employment. Factors such as relation to the job, age and time of offense, seriousness, nature of the violation(s) and rehabilitation will be taken into account.) If None Write None (Massachusetts applicants: should not include misdemeanor convictions more than five years old)

None

Important: Failure to list information will result in termination for false application-Be sure to list all information regardless of age.

Yes
No

Yes
No

Yes
No

Yes
No

Yes
No

Yes
No

Have you ever been convicted of, or forfeited bond or collateral for any of he following offenses committed after December 31, 1970?

A felony involving the use of a motor vehicle?

Yes
No

A crime involving the manufacturing, knowing transportation, knowing possession, sale or habitual use of amphetamines, a narcotic drug, a formulation of an amphetamine, or a narcotic drug?

Yes
No

Operation of a motor vehicle under the influence of alcohol, an amphetamine, a narcotic drug, a formulation of an amphetamine, or a derivative of a narcotic drug?

Yes
No

Leaving the scene of an accident if the accident resulted in personal injury or death?

Yes
No

Any other motor vehicle law violations, INCLUDE ALL CARELESS RECKLESS DRIVING VIOLATIONS

Yes
No

Have you ever had any license to operate a motor vehicle denied, revoked, or suspended

Yes
No

Yes
No

As per section 40.25(j) have you tested positive, or refused to test, on any pre-employment drug or alcohol test administered by an employer to which you applied for, but did not obtain, a safety-sensitive transportation work covered by DOT agency drug and alcohol testing rules.

Yes
No

If you answered yes, can you provide/obtain proof that you hav successfully completed the DOT return-to-duty requirements?

Yes
No

MOTOR VEHICLE DRIVER CERTIFICATION: I certify that the above is a true and complete list of all traffic violations (other than parking violations) for which I have been convicted, as well as accidents, criminal convictions, etc. I further understand that failure to list such items will be considered a false application.

Agree
Disagree

Employment History: Start with the most recent position & include all employers for he LAST TEN YEARS. List ALL gaps in employment including unemployed periods. DO NOT WRITE SEE ATTACHED RESUME. DO NOT WRITE PERSONAL AS A REASON FOR LEAVING A PRIOR EMPLOYER. COMPLETE ALL INFORMATION BELOW

Were you subject to the FMCSRs (DOT Regulations)?

Yes
No

Was your job designated as a Safety Sensitive function subject to 49 CFR Part 40 Drug and Alcohol Testing

Yes
No

Were you subject to the FMCSRs (DOT Regulations)?

Yes
No

Was your job designated as a Safety Sensitive function subject to 49 CFR Part 40 Drug and Alcohol Testing

Yes
No

Were you subject to the FMCSRs (DOT Regulations)?

Yes
No

Was your job designated as a Safety Sensitive function subject to 49 CFR Part 40 Drug and Alcohol Testing

Yes
No

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 Metropolitan Trucking, Inc.(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 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 assignments to projects related to the Customer, permission to be on the Customer’s 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 or record to furnish Metropolitan Trucking, Inc. information concerning my 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 tests taken by me, including the date and type of test for any refusals by me to take a drug or alcohol test, to the Director of Driver Personnel, or the Employment Placement Specialist assigned to process my application at Metropolitan Trucking, Inc. 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 refusal 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.

Agree
Disagree