HMTI Pre‑Admission Screening & Medical Questionnaire

Documents required to apply: Gather the following documents and email them to admissions.hmti@gmail.com.

Current driver’s license (must be valid; out‑of‑state licenses accepted)
Social security card or copy
Proof of residency (click here for examples)
Birth certificate (certified original or certified copy) or valid passport
CDIB card (if applying for tribal funding)

Please read this form carefully and complete it in its entirety. Incomplete forms will not be processed.

Thank you for your response. ✨

Thank you for submitting your Pre‑Admission Screening and Medical Questionnaire. We’ve received your information, and an Admissions Specialist will be reaching out to you soon.

ZERO-TOLERANCE ELIGIBILITY

1. Can you read, write, speak, and understand English? (If “No,” this application cannot be accepted.) (required)

Yes No

2. Can you pass a DOT drug screen? (If “No,” this application cannot be accepted.) (required)

Yes No

STUDENT INFORMATION

3. If you talked to an HMTI Academic Advisor, what is their name?

4. Full Legal Name

5. Date of Birth (MM/DD/YYYY)

6. Address, City, State, ZIP

7. Phone Number

8. Best time to call

9. Email

10. How did you hear about us?(required)

Found online (Google, Bing, etc.) Found on social media (Facebook, Twitter, etc.) Met at an event Saw a flyer or brochure Saw a billboard Referred by a friend or family member Referred by Workforce or Cherokee Nation

EDUCATION

11. High School Name, Address, City, State, ZIP

12. Did you receive a high school diploma or equivalent?(required)

Yes No

SEX OFFENDER STATUS

It is unlawful for any person registered as a sex offender to work with or provide services to children or to work on school premises.

13. Are you registered under the Sex Offenders Act? (If “Yes,” contact the HMTI Director before proceeding.)(required)

Yes No

TRIBAL AFFILIATION / CDIB

Verification of Native American heritage must be provided for Indian Preference consideration.

14A. Are you a member of, or eligible for membership in, a federally recognized tribe?(required)

Yes No

14B. If yes, which tribe?

15. Can you furnish a Certificate of Degree of Indian Blood (CDIB) card?

Yes No

COURSE OPTIONS

16. Choose one HMTI course to study(required)

Commercial Driver's License (CDL) – Class A Commercial Driver's License (CDL) – Class B CDL Refresher Course Hazardous Materials Endorsement School Bus/Passenger Endorsement

17. Do you have any upcoming appointments or engagements that may interfere with class? (court, doctor appointments, vacation, etc.)

ESSAY QUESTIONS

Answer the following questions using complete sentences. Be prepared to discuss your answers during your interview.

18. Do you have any experience driving a Class A truck and/or trailer?

19. What are your plans after completing a program at Heavy Metal Training Institute?

DOT MEDICAL QUESTIONS

These questions are required to determine your ability to pass the FMCSA‑required DOT physical.

20. Do you have a medical marijuana card? MMC’s must be surrendered to the OMMA before starting class.(required)

Yes No

21. Have you ever had a stroke?(required)

Yes No

22. Have you ever had a seizure or been diagnosed with epilepsy?(required)

Yes No

23. Have you ever been diagnosed with monocular vision?(required)

Yes No

24. Have you ever been diagnosed with Meniere’s disease?(required)

Yes No

25. Have you ever been diagnosed with high blood pressure?(required)

Yes No

26A. Have you ever been diagnosed with diabetes?(required)

Yes No

26B. If yes, what type?

27. Do you have any hearing problems?(required)

Yes No

28. Do you have any breathing problems?(required)

Yes No

29. Do you have a pacemaker?(required)

Yes No

30. Do you use a CPAP machine?(required)

Yes No

31. Do you have a prosthesis or prosthetic implant?(required)

Yes No

32A. Are you currently taking any medications?(required)

Yes No

32B. If yes, what type?

33. What surgeries have you had?

34A. Do you suffer from anxiety, panic attacks, PTSD, or depression?(required)

Yes No

34B. If yes, please explain:

All tuition must be paid in full prior to the first day of class in accordance with Heavy Metal Training Institute’s tuition policy. HMTI does not accept payment arrangements.

Heavy Metal Training Institute’s Cancellation & Refund Policies apply to both student withdrawals and school terminations. OAC 565:10-11-3(f) Application; “A school’s refund policy shall state its applicability to both school-determined and student-driven enrollment terminations.” These policies are as follows:

Cancellation Policy: A full refund of all monies paid will be issued if: 1) The applicant is not accepted; 2) The applicant cancels in writing within three days of enrollment or within three days after visiting the school (excluding weekends and holidays); 3) The school closes before training begins; and/or 4) The applicant cancels before attending classes or does not begin training. Refunds are issued within 30 days of the anticipated start date. If a program is discontinued after classes begin and students cannot be transferred to a comparable program, the school will provide a full refund of tuition (unless the institution closes).
Refund Policy: Refunds are based on the percentage of program hours completed: 1) within first 10% = 90% refund; 2) After 10% but within 25% = 75% refund; 3) After 25% but within 50% = 50% refund; and 4) After 50% = 0% refund. Non‑refundable charges: 1) $100 Withdrawal Fee; and 2) Books and supplies issued to the student. Books may be returned in new condition within 20 days for account credit. Refunds are issued within 30 days of withdrawal determination.

35. Applicant Acknowledgments. You must check every box to proceed.(required)

1. I understand that providing false, incomplete, or misleading information regarding my ability to read and write English, or my ability to pass the FMCSA‑required DOT physical and drug screen will result in immediate termination from the program. I further understand that if any misrepresentation is discovered at any time, a Misrepresentation Fee will be automatically assessed to cover administrative, scheduling, and funding‑related costs incurred as a result of my false statements. 2. I have read and agree to HMTI’s Drug & Alcohol Policy, and I agree to undergo a DOT drug screen and physical in order to obtain my CDL and Medical Card, if applicable. 3. I have read and agree to HMTI’s Tuition Policy, that all tuition must be paid in full prior to the first day of class. 4. I have read and agree to HMTI’s Refund Policy, in accordance with OAC 565:10-11-3. 5. I have read and agree to HMTI’s Cancellation Policy. 6. I have read and understand this Enrollment Agreement, and I agree to follow HMTI’s policies and procedures. 7. I understand that this application does not guarantee acceptance into the program.