2023 Driver of the Year Application

Candidate/Driver Information
Name*

First NameLast Name
Email Address*
Phone Number*

Area CodePhone Number
Mailing Address*

Street Address

City/State/Zip Code

City/State/ZipState / Province

Postal / Zip Code
Birth Date*

MonthDayYear
Drivers License*

NumberIssuing State
Driver's Hometown Newspaper
Nominator's Information
Name*

First NameLast Name
Title*
Company*
Contact Information*

Email AddressPhone Number
Preferred Contact Method

EmailPhone
Nominator Mailing Address*

Street Address

City/State/Zip Code

City/State/ZipState / Province

Postal / Zip Code
Candidate Profile
Include Motor Vehicle Report (Dated within 60 days of application submission)*

Browse Files

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Candidate's Employer*
Employer's Address*

Street Address

City/State/Zip Code

City/State/ZipState / Province

Postal / Zip Code
Employer's Contact Information (if different from nominator)

Phone NumberEmail Address
Employer's Hometown Newspaper
Company Website
Owner Operator*

YesNo
Years the candidate has been a professional truck driver*
Candidate's career accumulated miles*
Has the candidate ever been involved in an accident, either preventable, non-preventable, or DOT reportable, while driving a truck?*

YesNo
If Yes, describe each accident making sure to include: a) date of occurrence; b) circumstances; and c) whether the accident was ruled preventable or non-preventable
If involved in a preventable accident, list miles accumulated since then and date of last accident:

MilesDate
Additional Information
List any industry-related honors or awards the driver has won including company awards with the year recognized (i.e. truck driving championships, safe driving awards, etc.)
Please explain in 350 words or less why this individual should be selected as Driver of the Year. Describe what sets them apart from colleagues, what dothey do to improve the image of the trucking industry (i.e. mentoring to other drivers, community service activities, civic group participation, etc.) *
Please include a print-quality photograph featuring the nominee's head and shoulders, taken within the last year. The photo may be used for publicity purposes should the driver be selected.

Browse Files

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Statement of Agreement

In consideration of the nominated driver being allowed to participate in the program, the company certifies and agrees to the following:

• All of the statements contained in the application submitted in support of the nomination are true to the best of the company’s knowledge. The company, to the best of its ability, has investigated the statements and facts contained herein.

• The winning driver and company representative agree to being photographed and/or videotaped during the award ceremony and appreciation event for use in DMC communications regarding the Driver of the Year award program.
Nominator's Signature

Clear
Full NameTitle
CompanyDate
Should be Empty: