40ft Hot Shot (Dually) Sign up

PLEASE SEE THE BELOW FORM:

**There are NO CONTRACTS, Cancel anytime with a 24 Hr Notice***

**AVG WEEKLY RATES ARE UP TO $7500/WEEK

**THE ABOVE NUMBERS ARE BASED OFF OUR CURRENT DRIVERS RUNNING REGIONAL OR OTR**

Please complete the below profile. Once this is complete, a rep from our management team will work on getting the account set up. Once complete the account will be assigned to a agent. Keep in mind that a rep cannot start working on your loads until this is complete. If you have any questions about the form, please contact us @ 870-209-8924 or info@mainstreamlogisticstransport.com
COMPANY NAME*
DOT#*
EIN#(DO NOT ENTER SS#)*
DOT#*
OWNER'S NAME*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
PLEASE UPLOAD: AUTHORITY(MC)*

Cancelof
PLEASE UPLOAD: CERTIFICATE OF INSURANCE( NO ID CARDS)*

Cancelof
PLEASE UPLOAD: W9*

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Type a question

HOT SHOT (CDL)
TRUCK AND TRAILER #*
SUPPLIES*

TARPSCHAINSSTRAPSVBOARDSDUNNAGEWINCHAIR RIDE TRAILERBINDERSCOIL RACKSMEGA RAMPSOther
PLEASE SELECT ALL THE APPLIES TO THE DRIVER*

TWIC CARD20 YR CLEAN BACKGROUND(MILITARY LOADS)TANKERS ENDORSEMENTHAZMAT CERTHAZMET ENDORSEMENTPPEELDOther
DRIVER'S NAME*
IF YOUR DRIVER IS AN EMPLOYEE, WOULD YOU LIKE FOR THEM TO SEE THE FULL RATE DETAILS OR ADDRESS ONLY?*
ENTER TRUCK#,TRAILER# AND PH# OF DRIVER.*
MAX WEIGHT YOU CAN HAUL ON TRAILER?(CANNOT EXCEED 22,000LBS)*
PREFERRED HOME TIME?*
FACTORING PHONE, EMAIL NAME
INSURANCE CO, PH#,EMAIL:*
ANY OTHER DETAILS? PLEASE ENTER BELOW
LOCATION FOR THE FIRST LOAD?*
Desired Start Date?*

MonthDayYear
Date
Please choose a plan: Each plan includes free monthly DOT Inspection Reports and Credit Checks****

8% DISPATCHING9% INCLUDES INVOICE UPLOADS
Please sign and Date:

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