Fillable To register For These Sessions Or To Get More Information please (American Alliance Drug Testing)

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To register For These Sessions Or To Get More Information please (American Alliance Drug Testing)

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AADT/WSTA Member __________ X _________ = Total _______________
Member ID: ____________________
(No. of Attend.) (Cost) (Grand Total)
Payment:
q
Check
q
Visa
q
MasterCard
q
AMEX CC No. __________ - __________ - __________ - __________ Exp: _________
Cardholder Name: __________________________________________________________________________________________________
All NSF checks returned are subject to a $35 handling fee. For billing questions contact Dianna Webster - (909) 982-8409 Ext. 219
Billing address for card:
Company: _______________________________________________________________________________________________________________
Address: __________________________________________________ City: __________________________State: _______ Zip: _______________
Company Phone: (_____) ________________________________________ Fax: (_____) ________________________________________________
Email adress: ____________________________________________________________________________________________________________
Signature: ____________________________________________________________________________________ Date: _____________________
(With my signature I am authorizing AADT to charge my credit card for the total fees due)
Attendee Name(s):
Name: ______________________________________________________ Name: _____________________________________________________
Name: ______________________________________________________ Name: _____________________________________________________
Register by fax at (909) 608-2058 or mail to AADT 334 N. Euclid Ave, Upland CA 91786. If you would like additional information or have questions about our program, contact a AADT team member at
(909) 982-8409 or online at aadrugtesting.com Unable to attend? AADT has Supervisor Training Video available for purchase, contact us for more information.
DOT Drug and Alcohol Supervisor
Reasonable Suspicion Training
Sponsored by AADT
ARE YOU IN COMPLIANCE WITH THE DOT CFR 49 PART 382 REQUIREMENTS FOR
DRUG & ALCOHOL SUPERVISOR REASONABLE SUSPICION TRAINING?
This class is designed for employer’s/employees who supervise individuals that are involved in a
safety-sensitive position, and are required to have a minimum of one hour of training on controlled
substances and one hour on alcohol to aid on the recognition of the sign and symptoms of substance
abuse. Not only does this class satisfy the DOT requirements, but it is a great training tool for any
employer/ employee that supervises individuals in the workplace or those who want to refresh their
training.
Don’t miss this opportunity....
Saturday and Sunday - September 24
th
and 25
th
2016
Fresno Convention Center, Fresno, CA
Classes are scheduled during the West American Truck Show
Sat & Sun 1:00 PM to 3:00 PM
Please arrive 15 min. before class schedule. No one will be admitted once the class begins.
Pre-Register Now and Save!
$69 - Early Bird Pricing before August 30th
Classes will be an additional $10 per person after August 30th and enrollment is subject to availability. Cancellation request
must be received no later than 10 days prior to the class and are subject to a $25 cancellation fee per person. No-shows are
not eligible for a refund. Conrmation of enrollment including time and location will be sent to you 14 days prior to class date.
DOT DRUG & ALCOHOL SUPERVISOR REASONABLE SUSPICION TRAINING
COMPANY INFORMATION
Please Select Type VHS DVD
Video Kit (Members Only) ..................................................... $99.00 X ___________= $ ______________
Video Kit (Non-Members) .................................................... $120.00 X ____________= $ ______________
Additional Quiz & Certicate Kits ............................................ $20.00 X ____________= $ ______________
Total $ ______________
*AADT reserves the right to modify prices,
service and programs without notice.
*Note: All sales are nal, no refunds.
Company Name ______________________________________________________________________________________________________ ID# ________________________
(AADT CLIENTS ONLY)
Contact Name ____________________________________________________________________________ Phone ( ) _______________________________________
Address ______________________________________________________________________ City _____________________________________________________________
State __________________________ Zip __________________________ (SUPERVISOR KITS ARE SHIPPED VIA UPS TO PHYSICAL ADDRESS AND PRIORITY MAIL TO P.O. BOX NUMBERS)
ORDER INFORMATION
PAYMENT
MasterCard Visa American Express Discover Cash Check / Money Order #_________________________
(MAKE CHECKS OR MONEY ORDERS PAYABLE TO AADT)
Card No. ____________________ - _____________________- _____________________ - ________________________ Exp.Date ________ / _________
Note: All NSF check returns will be subject to the service charge stated on the current AADT Price List & Consortium Agreement.
Card Holder Name ____________________________________________________________________________________
(Print name as it appears on credit card)
Signature X ________________________________________________________________________________________ Date ___________________
(With my signature I am authorizing AADT to charge my credit card for the total fees due)
HAVE YOU HAD YOUR
SUPERVISORS TRAINED YET?
IT IS REQUIRED UNDER DOT-FMCSA 49 CFR PART 382
According to §382.603 Training for Supervisors - Every employer shall ensure that persons designated to determine whether reasonable suspicion exists. In order
to require a driver to undergo testing under §382.603, they must receive at least 60 minutes of training on alcohol misuse and 60 minutes of training on controlled
substance use. The training shall cover the physical, behavioral, speech and performance indicators of probable alcohol misuse and use of controlled substances.
AADT SUPERVISOR TRAINING KIT
AADT offers a ve part training program, where you will learn:
l The effect of drug and alcohol abuse in the workplace.
l Job performance behaviors that indicate the possible inuence of drugs or alcohol.
l How to use constructive confrontation to address performance issues when drug
or alcohol use is suspected.
l
Details about drug and alcohol testing procedures.
l How to handle employee defense tactics, which are designed to deter you from initiating
testing or disciplinary measures.
Upon completion of the training and passing our required quiz, the trainee will receive
a certificate and will be authorized to initiate “Reasonable Suspicion” testing as
defined in §382.307.
All Kits Include: DVD, 2 Leader Guides and a Program Quiz
TO ORDER - COMPLETE AND RETURN THIS FORM TO:
American Alliance Drug Testing • 334 N. Euclid Avenue • Upland, CA 91786-6031 or
Fax: 909-608-2058 / Email: cs@aadrugtesting.com
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Completed 15 July 2020

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