MJL LOGISTICS SOLUTIONS
OWNER-OPERATOR REGISTRATION FORM
Full Name
*
First Name
Last Name
Company Name
Phone Number
*
E-mail
example@example.com
Preferred Contact Method
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Phone
Email
Text
How did you hear about us?
*
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Referral
Social Media
Flyer
Other
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*
Truck & Trailer Details
*
Rows
Type of Truck
Trailer Type
MC or DOT Number
1
2
3
4
5
PROOF OF CDL (if Applicable)
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Proof of Insurance
*
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W-9
*
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Once this form is submitted and reviewed, you will receive the Freight Dispatch Agreement to the email that you listed above. The Carrier acknowledges and agrees that the agreement is a prerequisite to receiving dispatching services from MJL Logistic Solutions. No services will be rendered until the agreement is fully executed. The agreement outlines the terms and conditions governing the relationship between the Carrier and MJL Logistic Solutions, including but not limited to, dispatching services, payment terms, and responsibilities of both parties. Failure to sign and return the agreement will result in the inability to receive dispatch services. Please confirm that you understand by typing your name below.
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Type Full Name
Acknowledgment
*
All information and documents are true, accurate and complete to the best of my knowledge and belief.
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