Test - Fly Theme

First Name*(Required)

Last Name*(Required)

Email(Required)

Phone(Required)

Date(Required)

Company Name

Do you have a CDL?

YES

How long have you held a CDL? *(Required)

Upload a picture of your driver’s current CDL *(Required)

Drop files here or

Accepted file types: ie, jpeg, jpg, gif, png, pdf, Max. file size: 300 MB.

Please upload a photo of your driver’s previous CDL as proof of experience. *(Required)

Drop files here or

Max. file size: 300 MB.

Do you have your own authority? *(Required)

YES

License State *(Required)

License number *(Required)

Home Address *(Required)

Street Address Line 2(Required)

City(Required)

State / Province(Required)

Postal / Zip Code(Required)

Have you at this address for less than 3 years? *(Required)

YES

If YES, please provide your previous address:

Street Address Line 2

City

State / Province

Postal / Zip Code

Do you have an existing DOT or MC number?

YES

If so, please provide your DOT or MC number here:

What type of equipment do you have? *(Required)

Tractor

Reefer

DrYvan

Flatbed

Other

Kindly provide the year (must be 2000 or newer), make, model, VIN, and tag for all available equipment. Save after each entry to add multiple trucks. *(Required)

Year

Make

Model

vin

Tag

What type of signage is suitable for this truck? *(Required)

YES

Is your truck owned or financed?

If it is financed, is there a co signer?

Please Note: If there is a co signer, we will need permission from them and they will need to sign the lease agreement as well.

Value of each piece of equipment *(Required)

To comply with regulations, you must possess physical damage insurance. Kindly submit documentation as evidence of your physical damage insurance. *(Required)

Drop files here or

Accepted file types: (ie, jpg, gif, png, pdf), Max. file size: 300 MB.

It is mandatory to possess Bobtail Insurance. Kindly submit the necessary documentation as proof of your Bobtail insurance coverage. *(Required)

Drop files here or

Accepted file types: (ie, jpg, gif, png, pdf), Max. file size: 300 MB.

Upload your cab card *(Required)

Drop files here or

Accepted file types: (ie, jpg, gif, png, pdf), Max. file size: 300 MB.

To process your cab card request, kindly submit a copy of Form 2290. *(Required)

Drop files here or

Accepted file types: (ie, jpg, gif, png, pdf), Max. file size: 300 MB.

Location *

City(Required)

State(Required)

Region(Required)

If you chose YES, kindly detail any limitations in the provided box. If you selected NO, input "N/A" in the box. *(Required)

Are there any location-based service restrictions? *(Required)

YES

Do you have a Motive ELD? *(Required)

YES

Kindly furnish an email address for ELD registration along with one (1) alternative email address. *(Required)

Do you plan to utilize your personal fuel card? *(Required)

YES

Kindly provide the following information for each driver. Save your entries to add multiple drivers.*

FIRST & LAST NAME(Required)

PHONE NUMBER(Required)

EMAIL(Required)

Upload a photo of your registration *(Required)

Drop files here or

Accepted file types: (ie, jpg, gif, png, pdf), Max. file size: 300 MB.

Upload a photo of your MVR issued in the last 30 days. *(Required)

Drop files here or

Accepted file types: (ie, jpg, gif, png, pdf), Max. file size: 300 MB.

Upload a photo of your current medical card. *(Required)

Drop files here or

Max. file size: 300 MB.

Upload a photo of your current DOT inspection. *(Required)

Drop files here or

Max. file size: 300 MB.

Kindly submit your latest Roadside Inspection report from the state. If not available, please coordinate with your state DOT to schedule one. *(Required)

Drop files here or

Max. file size: 300 MB.

Have you had any traffic violations in the past 3 years? *(Required)

YES

Preferred Lanes*(Required)

What states are you willing to travel

What is your preferred duration for being on the road?*(Required)

Do you have a clearing house? *(Required)

YES

If you answered "YES" enter clearing house below?

Bank Name and Address

Bank Account Number *(Required)

Bank Routing Number *(Required)

Social security number *(Required)

Client hereby commits to indemnify, defend, and absolve The Compass Circle, its officers, employees, affiliates, and agents from all losses, liabilities, claims, or damages asserted by third parties related to The Compass Circle's performance under the Agreement. This indemnification excludes losses resulting directly from the willful misconduct or gross negligence of The Compass Circle, as determined by a judicial authority.

In addition, the Client agrees to adhere to a strict no-refund policy. Furthermore, the Client undertakes to indemnify, defend, and protect The Compass Circle, along with its officers, employees, affiliates, and agents, against any losses, liabilities, claims, or damages asserted by third parties arising from misrepresentations, false, or misleading information made by the Client or its officers, employees, affiliates, or agents to any party, including Consulting.

Agree

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