This company is an equal opportunity employer dedicated to nondiscrimination in employment. This company selects the best qualified individual for the job based on job-related qualifications regardless or race, age, color, religion, sex, national origin, ancestry, marital status, sexual preference, disablity or any other basis protected by applicable law.
Answering "yes" to these questions does not constitute an automatic bar to employment. Factors such as age and time of the offense, seriousness and nature of the violation, and rehabilitation will be taken into account. (Do not include minor traffic citations, and arrests or convictions which have been sealed or expunged in answering this question.)
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In the event of my employment to a position in the Company, I will comply with all rules and regulations of the Company. I understand that the Company reserves the right to require me to submit to a test for the presence of drugs in my system prior to employment and at any time during my employment, to the extent permitted by law. I also understand that any offer of employment may be contingent upon the passing of a physical examination and a test for the presence of drugs and/or alcohol in my system, performed by a doctor selected by the Company. Further, I understand that at any time after I am hired, the Company may require me to submit to a physical examination and a drug and/or alcohol test, to the extent permitted by law. I consent to the disclosure of the results of any physical examination and related tests to the Company. I also understand that I may be required to take other tests such as personality tests or honesty tests, prior to employment and during my employment. I understand that should I decline to sign this consent or decline to take any of the above tests, my application for employment may be rejected or my employment may be terminated, I understand that for insurance purposes bonding may be a condition of hire. If it is, I will be so advised either before or after hiring and a bond application will have to be completed,
I understand that the Company may investigate my driving record and my criminal record and that an investigative consumer report may be prepared whereby information is obtained through personal interviews with my neighbors, friends, personal references, and others with whom I am acquainted, This inquiry includes information as to my character, general reputation, personal characteristics and mode of living. I understand that I have the right to make a written inquiry, within a reasonable period of time, to receive additional detailed information about the nature and scope of this investigation. I further understand that the Company may contact my previous employers and I authorize those employers to disclose to the Company all records and information pertinent to my employment with them. In addition to authorizing the release of any information regarding my employment, I hereby fully waive any rights or claims I have or may have against my former employers, their agents, employees and representatives, as well as other individuals who release information to the Company, and release them from any and all liability, claims, or damages that may directly or indirectly result from the use, disclosure, or release of any such information by any person or party, whether such information is favorable or unfavorable to me. I authorize the persons named by me as personal references to provide the Company with any pertinent information they may have regarding myself.
I hereby state that all the information that I provided on this application or any other documents filled out in connection with my employment, and in any interview are true and correct. I have withheld nothing that would, if disclosed, affect this application unfavorably. I understand that if I am employed and any such information is later found to be false or incomplete in any respect, I may be dismissed. I understand if selected for hire, it will be necessary for me to provide satisfactory evidence of my identity and legal authority to work in the United States, and that federal immigration laws require me to complete an 1-9 Form.
If hired, I agree as follows: My employment and compensation is terminable at-will, is for no definite period, and my employment and compensation may be terminated by the Company (employer) at any time and for any reason whatsoever, with or without good cause at the option of either the Company or myself. No implied, oral, or written agreements contrary to the express language of this agreement are valid unless they are in writing and signed by the President of the Company (or majority owner or owners if Company is not a corporation). No supervisor or representative of the Company, other than the President of the Company (or majority owner or owners if Company is not a corporation), has the authority to make any agreements contrary to the foregoing. This agreement is the entire agreement between the Company and myself regarding the rights of the Company or myself to terminate employment with or without good cause, and this agreement takes the place of all prior and contemporaneous agreements, representations, and understandings of myself and the Company.
I also acknowledge that the Company utilizes a system of alternative dispute resolution which involves binding arbitration to resolve all disputes which may arise out of the employment context. Because of the mutual benefits (such as reduced expense and increased efficiency) which private binding arbitration can provide both the Company and myself, both the Company and I agree that any claim, dispute, and/or controversy (including, but not limited to, any claims of discrimination and harassment, whether they be based on Title Vll of the Civil Rights Act of 1964, as amended, as well as all other state or federal laws or regulations) that either I or the Company (or its owners, directors, officers, managers, employees, agents, and parties affiliated with its employee benefit and health plans) may have against each other which would otherwise require or allow resort to any court or other governmental dispute resolution forum arising from, related to, or having any relationship or connection whatsoever with my seeking employment with, employment by, or other association with the Company, whether based on tort, contract, statutory, or equitable law, or otherwise, (with the sole exception of claims arising under the National Labor Relations Act which are brought before the National Labor Relations Board, claims for medical and disability benefits under Workers' Compensation, and Unemployment Compensation claims filed with the state) shall be submitted to and determined exclusively by binding arbitration under the Federal Arbitration Act in conformity with the procedures of the Uniform Arbitration Act and theTennessee Code Annotated, 5 29-5-01 et seq. as may be amended from time to time. However in addition to requirements imposed by law, any arbitrator herein shall be a retired Tennessee Circuit Court Judge and shall be subject to disqualification on the same grounds as would apply to a judge of such court. To the extent applicable in civil actions in United States District Courts, the following shall apply and be observed: all rules of pleading, discovery, and evidence (including the right to resolution of the dispute by means of motions for summary judgment, judgment on pleadings, Resolution of the dispute shall be based solely upon the law governing the claims and defenses pleaded, and the arbitrator may not invoke any basis (including but not limited to, notions of "just cause") other than such controlling law. The arbitrator shall have the immunity of a judicial officer from civil liability when acting in the capacity of an arbitrator, which immunity supplements any other existing immunity. Likewise, all communications during or in connection with the arbitration proceedings are privileged. As reasonably required to allow full use and benefit of this agreement, the arbitrator shall extend the times set for the giving of notices and setting of hearings. Awards shall include the arbitrator's written reasoned opinion and, at either party's written request within 10 days after issuance of the award, shall be subject to affirmation, reversal or modification, following review of the record and arguments of the parties by a second arbitrator who shall, as far as practicable, proceed according to the law and procedures applicable
to appellate review by the Tennessee Court of Appeals of a civil judgment following court trial. Should any term or provision, or portion thereof, be declared void or unenforceable it shall be severed and the remainder of this agreement shall be enforceable. I UNDERSTAND THAT BY VOLUNTARILY AGREEING TOTHIS BINDING ARBITRATION PROVISION, BOTH I AND THE COMPANY GIVE UP
OUR RIGHTSTOTRIAL BY JURY OF ANY CLAIM I OR THE COMPANY MAY HAVE AGAINST EACH OTHER,
I further understand that this voluntary alternative dispute resolution program covers claims of discrimination or harassment under Title Vll of the Civil Rights Act of 1964, as amended. By marking the box to the right, I elect to waive the benefits of arbitrating Title Vll claims. C]
The at-will employment and/or alternate dispute resolution process referred to above are inapplicable and superseded only to the extent they conflict with any union or collective bargaining agreement for which you are covered.
If you have any questions regarding this statement, please ask a Company representative before signing.
Please provide addresses covering at least the last seven years.
I authorize the Company and/or its agents to request a consumer report or investigative consumer report about me for the purpose of evaluating me for employment, promotion, reassignment or retention as an employee. I understand that background reports will be requested on me, including credit reports, criminal convictions, employment history, education, professional references, personal references, civil court fi lings, driving records, and insurance records. These reports will include information as to my character, general reputation, personal characteristics, mode of living, work habits, salary history, performance, education, experience, reasons for termination of employment and any history of criminal, dishonest or violent behavior. Further I understand that requests for information will be made of various private and government agencies which maintain records concerning my past activities,
I release the Company and/or its agents and any person or entity, which provides information pursuant to this authorization from any and all liability claims or damages that may directly or indirectly result from the use, disclosure, or release of any such information by any person or whether such information is favorable or unfavorable to me.
I understand that I have the right to make a written inquiry within a reasonable period of time to receive additional detailed information about the nature and scope of this Investigation.
This Background Check Authorization is inapplicable and superseded only to the extent it conflicts with any union and/or collective bargaining agreement for which you are covered.
Company Policy: Impairment related to drug or alcohol use is not tolerated in any way. Employees who are in a condition which would impair their ability to perform their job, endanger the safety of themselves or others, cause equipment or property damage, or otherwise expose the company to potential liability will not be allowed to continue working or to remain in the workplace. This rule applies to anyone who is ill, fatigued or otherwise incapable of performing his or her job.
For these reasons, impairment is defined to include, but not limited to the inability to perform one's job in the manner prescribed for that function or in accordance with established practice. Such impairment may include but is not limited to the inability to use or operate equipment or tools properly, to communicate clearly, to exercise reasonable judgment in making decisions, to interact with other employees or business contacts in an appropriate manner, or to engage in other appropriate personal behavior. Such impairment, when caused by drug or alcohol abuse, is a violation of this company's policy.
Notice of Testing: I hereby acknowledge that it is the policy of this company that all candidates for employment or continued employment must submit a sample of their urine and/or hair follicle for chemical or other analysis. I further understand that the purpose of this analysis is to determine or rule out the presence of non-prescribed or prohibited controlled substances. I hereby freely and voluntarily consent to this request for a specimen and agree to participate in the testing program.
Medication Disclosure: Please list below all drugs and/or medications (including prescription and non-prescription) and the date of use that you have taken in the last 30 days.
I hereby authorize Michael's Tree and Loader Service, LLC to receive information from my Department of Transportation regulated drug and alcohol testing records by my previous employers.
This release is in accordance with regulation FMCSA Part 391.23, Investigation and Inquiries.
By signing below, I hereby authorize the release of all information concerning DOT drug and alcohol testing violations including pre-employment tests during the past three years.
In compliance with FMCSA regulation 391.23 part (i)(1) you have certain rights regarding the investigative information that will be provided to the prospective employer:
i) You have the right to review information provided by previous employers;
ii) You have the right to have errors in the information corrected by the previous employer and for that previous employer to re-send the corrected information to the prospective employer;
iii) You have the right to have a rebuttal statement attached to the alleged erroneous information, if the previous employer and the driver cannot agree on the accuracy of the information.
(2) Drivers who have previous DOT regulated employment history in the preceding three years and wish to review previous employer investigative information must submit a writtn request to the prospective employer. This may be done at any time, including when applying, or as late as 30 days after being employed or being notified of denial of eployment. The prospective emplyer must provide this information within five business days of receiving the written request. If the prospective employer has not yet recieved the requested information from the previous employer, then the five-business day deadline will begin when the prospective employer receives the requested safety performance history information. If the driver has not arranged to pick up or reveive the requested records within 30 days of the prospective emploter making them available, the prospective employer may consider you to have waived your reques to review the records.
Part 391.23(e) In addition to the investigations required by paragraph (d) of this section, the prospective motor carrier employers must investigate the information listed below in this paragraph from all previous DOT regulated employers that employed the driver within the previous three years from the date of the employment application, in a safety-sensitive function that required alcohol and controlled substance testing specified by 49 CFR part 40(e)(1) Whether, within the previous three years, the driver had violated the alcohol and controlled substances prohibitions under subpart B of part 382 of this chapter, or 49 CFR part 40
Please click here to download and print the I-9 Employment Eligibility Verification Form. Fill it out and mail it to:
Michael's Tree and Loader Service, LLC 3800 Knight Arnold Rd Memphis,TN,38118
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