DOT Consortium Enrollment/Renewal DOT Random Drug Testing Your DOT Consortium (Random Testing) Membership includes selection notifications, testing center scheduling, Certificate of Compliance and MIS reporting. You are only charged for a drug or alcohol test if you are selected. Please complete the required information and payment method below and your new certificate of Compliance/enrollment will be emailed and sent by US Mail.DOT Mode*FMCSAFRAFRA (MOW)FTAFAAPHMSAUSCGMembership Term*1 year2 year3 YearCompany Name*Company 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 Contact Phone Number*Consortium Member Info*First NameLast NameCDL/SS# Billing Email (To receive your receipt of purchase)* Total $0.00 Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date Security Code Cardholder Name
