Driver Qualification File Application Info

DRIVER QUALIFICATION FILE APPLICATION INFORMATION

Fill out the form below in its entirety.

The information provided will be used when processing your driver qualification file. Please be sure to confirm that all the information you enter is accurate, up-to-date and spelled correctly.

Please be sure that your contact information is accurate; it is likely that we will reach out to you while we are processing your application to ensure accuracy and verify compliance with any other relevant laws and regulations.

Upon submitting the application, you will be redirected to our product page, where you can pay for and complete your online driver qualification. If you have any questions, or you need to register multiple drivers, you may reach us Monday-Friday from 7:00 am to 6 pm (mountain time) at 1-877-352-1996.

Your Contact Information

First Name (required)

Last Name (required)

Your Email (required)

Your Telephone Number (required)

Company Information

Company Legal Name (required)

USDOT Number (required)

Phone Number (required)

Company Address (required)

Driver's Information

Full legal name (required)

Current address (required)

Previous addresses within the last three years, in chronological order starting with most recent (required)

Current phone number (required)

Secondary phone number

Date of birth

Last four of social security (required)

Current Driver License Number (required)

Class type of license (required)

License Endorsements if applicable

License Expiration date (required)

List any drivers licenses held in any states in the last three years (required)

Driver license Information for any licenses in any states in the last three years

Vehicle Currently Driven

VIN Number

Make and Model

Year

GVWR

10 Year Work History

Company 1

Name of company

Address of company

Phone number of company

Supervisor name

Dates of Employment (month and year)

Reason for leaving

Did you operate a CMV over 10001 LBS GVWR for this company
yesno

Were you subject to Drug and Alcohol testing under FMCSA regulation
yesno

Company 2

Name of company

Address of company at least city and state

Phone number of company

Supervisors name

Dates of Employment (month and year)

Reason for leaving

Did you operate a CMV over 10001 LBS GVWR for this company
yesno

Were you subject to Drug and Alcohol testing under FMCSA regulation
yesno

Company 3

Name of company

Address of company at least city and state

Phone number of company

Supervisor name

Dates of Employment (month and year)

Reason for leaving

Did you operate a CMV over 10001 LBS GVWR for this company
yesno

Were you subject to Drug and Alcohol testing under FMCSA regulation
yesno

Driving Record Information

In the last 3 years have you received any traffic violations
yesno

If yes, briefly describe each violation and whether this violation was received in a personal or commercial vehicle.

In the last 3 years have you been involved in any accidents
yesno

If yes, briefly describe each accident, if you were found at fault for the accident(s), and whether this accident was in a personal or commercial vehicle.

Have you ever had your license denied suspended revoked or canceled
yesno

If yes please provide the license number, the year of action and a brief reason why

Have you ever tested positive or refused to test on a pre-employment drug screening
yesno

If yes, please give the month and year

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