Carrier Intake Form

Which services are you looking for?*

Full time dispatch & back office services (booking loads, rate confirmations, invoicing, broker setup packets)Dispatch services only ( booking loads only)As-Needed Loads onlyBack office services only (rate confirmations, invoicing, broker setup packets)

What is your cost per mile (CPM)?*

Average rate per mile expected?*

Days you operate?*

Mon-FriMon-SatMon-Sun

Have You Ever Been Terminated or Suspended by a Broker? If yes, explain*

Any Major Safety Violations? (if yes, explain)*

Do You Use a Load Board? If So, Which One(s)?*

I understand that this form is solely for vetting purposes. Submitting it does not guarantee my acceptance to work with SLT Business Consulting. I acknowledge that a formal agreement must be signed before any services can commence. We will contact you via text or email with the next steps within 24 to 48 business hours.*

Yes, I understandNo, I don't understand

We may reach out to you via text if we need additional information or to provide links for the next steps. Please check the box below to agree to our terms. Note that standard text message rates may apply depending on your carrier. We do not send any marketing or promotional text messages; this is strictly for business purposes.

Do you agree to receive text messages regarding SLT Business Consulting from 334-781-4981 at the number provided? Msg & data rates may apply. Reply STOP to no longer receive messages.*

Yes, I agreeNo, I do not agree

Signature*

Date*

Date