2021 MMTA Trucker Knowledge Competition Registration Step 1 of 2 50% Contestant's Name* First Last PLEASE NOTE: You MUST use this name when asked during Kahoot sign-in. Using a different name will disqualify you from winning any prizes.Contestant's Home Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contestant's Email*Please type carefully. We will email you the PIN to access the competition at 6pm on July 31st. Contestant's Cell Phone*Competition State**Competition is for Maine CDL holders working for company with a Maine terminal.Employer Name*Can you confirm you have been continuously employed by the company listed above from August 15, 2020 to the present?*YesNoCan you confirm you are crash free from August 15, 2020 to the present?*YesNoDo you have a copy of your current MVR to upload to us?*If you don't, no worries. We will contact your employer to get a copy.YesNoPlease upload a current version of your MVR driving report CERTIFICATIONCERTIFICATION BY CONTESTANT* Yes, I agree to the following Contestant Certification and ReleaseI certify: 1. From August 15, 2020 to the present I have been continuously employed as a truck or step van driver by my present employer [exception: if previous employer went out of business and all other eligibility requirements are met]; and 2. From August 15, 2020 to the present I have driven and performed the regular duties of a truck driver or step van driver for that period, and that my regular duties of a truck driver or step van driver constituted not less than 60% of my work hours. 3. From August 15, 2020 to the present I have not been involved in a fleet motor vehicle or motor carrier vehicle crash in the course of such employment. 4. I have a Class A or Class B Commercial Driver’s License. If a Step Van driver, not required. 5. That I hold a CDL from or have been occupationally domiciled in the state of Maine. Occupational domiciled means the terminal, garage or other operating base from which the driver normally and usually works and/or is supervised. 6. I acknowledge that any misstatement made with respect to my eligibility for this competition may result in the forfeiture of my right to compete or in my disqualification from said competition. 7. I acknowledge that I am not in the employ of ATA or a State Trucking Association. 8. I grant the MMTA and ATA and its designated agencies exclusive right to make use of information about myself and any photographs subsequently taken under MMTA's or ATA’s direction, in publicity and advertising activities. 9. I agree that this event is intended to be a fun way to recognize the safety and professionalism of the trucking industry and that any rule interpretation will be at the sole discretion of the MMTA with their decision being final. I further grant the MMTA and ATA the right to examine my CDL and MVR for the purposes of determining my eligibility to compete at both the State and National virtual events.