I freely and voluntarily give my permission to submit to urinalysis and or other screening or tests as shall be determined by United Tribes Technical College (UTTC) under its administration of applicable regulations of the U.S. Department of Transportation (DOT) including 49 CFR Parts 40 and 382, UTTC Policy and in substantial compliance with applicable state statues pertaining to a Drug Free Workplace, if any, in the selection process of all applicants for employment, for the purpose of determining the presence of, and content of, any and all of the following substances:
- MDMA (Ecstasy)
- Phencyclidine (PCP)
- 6-Acetyl Morphine (Heroin)
I also understand and acknowledge that I may be subject to non-DOT screening and testing under UTTC Policy as set forth in the policy.
I further agree to and hereby authorize the release of the results of said tests to UTTC and to UTTC’s medical review officer and its Service Agents as provided in the policy.
I understand that a negative test is a pre-condition of employment with UTTC and the refusal to submit to testing or a positive test result will result in the rejection of my application or the rescinding of a conditional offer of employment. I also understand that it is not the purpose of this screen or test to identify any disability I may have and that pre-employment screening and testing activities are conducted in compliance with the ADA requirements applicable to UTTC if any.