Partner Carrier Application Form

Company Name:

Address:

Phone Number:

Operations Email:

POD Request Email:

Web Site:

Administrative Contact:

Fax Number:

Number of Tractors:

Company:

Owner Operator:

Number of Trailers:

Check all of the items below, specifying number and type, or check N/A if not applicable.

Other (Specify Number and Type)

Types of Transportation Services Provided

FTL

LTL

Domestic Canada

Interstate US

Inbound US to Canada

Outbound US to Canada

Satellite Tracking

EDI Capability

For any of the service areas below, please select N/A if not applicable based on regular inbound and/or outbound availability from region:

Canada Only N/A

Western Canada N/A

Maritimes N/A

Eastern Canada N/A

Midwest US N/A

Western US N/A

Eastern US N/A

North America N/A

US to US Points N/A

Mexico N/A