Carrier Dispatching Services Application

1
Full Name* This field is required.
First Name
Last Name
2
Company Name* This field is required.
3
Email Address* This field is required.
example@example.com
4
Phone Number* This field is required.By entering your number, you agree to receive informational messages from P35 Logistics at the number provided and agree to P35 Logistics Privacy Policy. Message frequency varies. Message & data rates may apply. Reply STOP to cancel. Reply HELP for info.
Please enter a valid phone number.
5
What kind of truck(s) do you have?* This field is required.Select all that apply
Please Select
Tractor - Power Only
Tractor with trailer
26' Box Truck
Hotshot - Power Only
Hotshot with trailer
None, I need a truck to drive
6
Do you have your own active MC and DOT?* This field is required.
YESNO
7
DOT Number* This field is required.
8
MC Number* This field is required.
9
How old is your authority? (in years)* This field is required.If it's less than 1 year, enter it as a decimal. For example, 6 months would be 0.5
10
Are there any gaps in your authority?* This field is required.
Please Select
Please Select
Yes
No
11
When was your authority re-instated?* This field is required.
12
Which services are you interested in?* This field is required.
Dispatching
Additional Staff
IFTA filing
Payroll and invoicing support
Driver onboarding
Driver recruiting and screening
DQ file management
Full HR support
13
Where are you willing to run? (Select all that apply)* This field is required.
Please Select
Please Select
Alabama
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michegan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
14
Name of your factoring company (if any)* This field is required.
15
Is your factoring company willing to pay the dispatching fees directly?* This field is required.
Yes
No
Unknown, but I prefer to pay the bill myself
16
How soon are you ready to roll?* This field is required.
17
When is the best time to contact you, and how do you prefer to communicate?* This field is required.
Should be Empty: