ADDITIONAL TRUCK / DRIVER SIGN UP
Company Name
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Are you signing up a New Driver or New Truck
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New Driver
New Truck
Please verify that you are human
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Equipment Type
*
Please Select
Tandem
Twinsteer
Truck & 3 Axle Trailer
PBS Truck & 3 Axle Trailer
Truck & 4 Axle Trailer
PBS Truck & 4 Axle Trailer
Live Bottom Semi 2 Axle
Live Bottom Semi 3 Axle
Earthmoving Equipment
OTHER
Please Specify Other or Earthmoving Equipment Type (E.g 5T Excavator or Street Sweeper)
Rego Number (If Earthmoving Equipment please type NA if not registered)
*
Make & Model
*
Year
*
Trailer Registration (if Applicable)
Please tick the applicable for Tippers / Trucks
*
Asphalt Spec
Steel Body
Alloy Body
Cab Over Truck
Bonnet Truck
Low Sides
Swinging Tailgate
Scales
Tarp
Flashing Roof Lights
Reverse Alarm
EPA
Tare Stickers
Turn Left Alarm
Wheel Nut Indicators
Spill Kit
Fire Extinguisher
First Aid Kit
Body Up Alarm
Reverse Camera
Battery Isolator
Hand Brake Alarm
Reverse Squawker
Side Under Run Protection
UHF
Warning Signage
N/A Earthmoving Equipment select below
Please tick the applicable for Tipper Trailers
Asphalt Spec
Steel Body
Alloy Body
Low Sides
Swinging Tailgate
Scales
Tarp
Reverse Alarm
EPA
Tare Stickers
Turn Left Alarm
Wheel Nut Indicators
Body Up Alarm
Reverse Squawker
Warning Signage
Please tick the applicable for Earthmoving Equipment
Hammer
Sorting Buckets
Augers
Sweeper Attachment
Profiler Attachment
Smudge Bar
Rock Grab
Tilt Hitch
Rubber Tracks
Steel Tracks
Other
Truck Tare (tons)
Truck GVM (tons)
Truck Payload (tons)
Truck & Trailer Tare (tons)
Truck & Trailer GVM (tons)
Truck & Trailer Payload (tons)
Please upload your Equipment Insurance (Must be a CERTIFICATE OF CURRENCY not Invoice)
*
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Truck Insurance Expiry Date (if Not Applicable please use todays date)
*
-
Day
-
Month
Year
Date
Please upload your current Risk Assessment for this Vehicle (within the last 12 months) AND your last service record
*
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Risk Assessment Date
*
-
Day
-
Month
Year
Date
Please upload your Registration Certificate for Truck & Trailer (if Applicable)
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Truck Registration Expiry Date
-
Day
-
Month
Year
Date
Trailer Registration Expiry Date (if Applicable)
-
Day
-
Month
Year
Date
Please upload a copy of your service, photo of your equipment and any other relevant documents E.g Mass or PBS Permits
*
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Submit
DRIVER DOCUMENTS
Name
*
First Name
Last Name
Job Title e.g Driver / Allocator & Driver / Owner Driver
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Drivers License Number
*
Drivers License Type
*
Please Select
HR
HC
MC
Any other conditions on your Drivers License
Drivers License Expiry Date
*
-
Day
-
Month
Year
Date
Please upload your Drivers License
*
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Please upload your White Card / Construction Induction
*
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White Card Issue Date
*
-
Day
-
Month
Year
Date
Rego of Vehicle and / or type of Equipment Operated by this Driver
*
Please specify any other tickets held by operators and attach them below
Please upload any RIW or EPA cards or tickets for machine operations or any other information here
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OPTIONAL QUESTIONS - Does the driver identify as any of the following:
*
Aboriginal or Torres Strait Islander
Veteran - Have served and no longer serving full time in Defence Force
Refugee / Asylum Seeker or Migrant
Having a disability including those with concealed disabilities such as diabetes, depression, anxiety, and other mental health disorders
Ex Offender
Prefer Not to Answer
Emergency Contact for Driver - Name
*
First Name
Last Name
Emergency Contact for Driver - Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
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