YOUR GATEWAY INTO THE TRUCKING INDUSTRY Name * First Name Last Name Company Name * Email * Tax ID/ EIN * Company address * Address 1 Address 2 City State/Province Zip/Postal Code Country Personal Address (if different from company) Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Authority Type * Select intrastate only if you will operate within your home state at all times Intrastate Interstate How many Trucks 1 2 3 4 5 6 7 8 9 10 How many Trailers 1 2 3 4 5 6 7 8 9 10 CDL Drivers 1 2 3 4 5 6 7 8 9 10 Type of Trailer Dry Van Reefer Flatbed Other type of trailer Please enter your trailer Type of cargo * Please describe what type of cargo you will be hauling Thank you! We will review your request and contact you with an invoice and/or follow up questions.
