Sprinter Van / Cargo Van Carrier Onboarding – Infinity Dispatch Services
Complete this form to get started with onboarding as a carrier with Infinity Dispatch Services.
Carrier & Company Information
Legal Company Name
*
DBA / Trade Name
Owner / Primary Contact Name
*
First Name
Middle Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
MC Number
DOT Number
Authority Active Date
-
Month
-
Day
Year
Date
Operating Status
Please Select
Active
Pending Activation
Inactive
Seasonal
Other
Payment, Insurance & Compliance Documents
Do you use factoring?
*
Yes
No
Factoring company name
Notice of Assignment (NOA)
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W-9 form
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Certificate of Insurance (COI)
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COI expiration date
-
Month
-
Day
Year
Date
Cargo insurance limit (USD)
Auto liability limit (USD)
Bank verification or voided check
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Payment method
*
Please Select
ACH
Check
Factoring
Other
Payment email
example@example.com
Remittance notes
Agreements, Permissions & Accessorial Acknowledgements
Consent to contact brokers and shippers
*
I authorize Infinity Dispatch Services to contact brokers and shippers on my behalf regarding load opportunities and dispatch coordination
I understand this may include sharing necessary business and availability information
Dispatch agreement acknowledgement
*
I have read and agree to the dispatch agreement terms
I understand dispatch services are provided subject to load availability and carrier qualification
Dispatch service fee terms will be confirmed in writing before dispatch service begins.
*
Acknowledge
Legal disclaimer acknowledgement
*
I acknowledge that Infinity Dispatch Services does not guarantee load volume, revenue, or profitability
I understand the carrier remains responsible for compliance with all applicable laws and regulations
Tracking consent
*
I consent to load tracking and status updates through approved tracking methods
I understand tracking may be required by brokers, shippers, or dispatch requirements
Accessorial charges acknowledgement
*
Detention
Layover
TONU
Wait Time
Driver Assistance
Extra Stops
Driver Information & Availability
Driver Name
First Name
Middle Name
Last Name
Driver Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Driver Email
*
example@example.com
Driver License Status
*
Please Select
Active
Suspended
Expired
Pending Renewal
Other
Medical Card Status
Please Select
Current
Expired
Not Applicable
Pending Review
Other
Availability Date and Time
Driving-Hours Notes
Earliest Available Date
-
Month
-
Day
Year
Date
Emergency Contact Name
First Name
Middle Name
Last Name
Emergency Contact Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Van / Equipment Details
Van Year
Van Make
Van Model
Van VIN
Van Plate Number
Van Unit Number
Van Type
Please Select
Cargo Van
Sprinter Van
High Roof Van
Extended Cargo Van
Other
High Roof?
Yes
No
Extended Length?
Yes
No
Inside Dimensions (L x W x H)
Door Opening Dimensions (W x H)
Max Payload (lbs)
Pallet Capacity
Loading Type
Please Select
Rear Load
Side Load
Rear and Side Load
Other
Dock Height or Ground Load Only?
Dock Height
Ground Load Only
Equipment Checklist
Straps
Blankets
Load Bars
E-Track
Pallet Jack
Ramps
Cargo Partition
Additional Equipment or Notes
Any Specialized Equipment Installed?
Yes
No
Service Profile
Operating Mode
Solo
Team
Freight Types Accepted
Expedited
Airport Cargo
Medical
High-Value
Residential Delivery
Driver Assistance
Palletized
Floor-Loaded
Maximum High-Value Load Limit (USD)
No-Hands-Only Unload Preference
Yes
No
Facility Restrictions
Gated Facilities
Limited Dock Access
Appointment Required
Strict Check-In
No Overnight Parking
Other
Expedited Freight Accepted
Yes
No
Airport Cargo Accepted
Yes
No
Medical Freight Accepted
Yes
No
Residential Delivery Accepted
Yes
No
Driver Assistance Accepted
Yes
No
Palletized Freight Accepted
Yes
No
Operating Preferences
Current Location
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Maximum Deadhead (miles)
Minimum RPM
Minimum Daily Rate (USD)
Minimum Load Rate (USD)
Preferred Lanes
No-Go States
Accept Loads Into Canada?
Yes
No
Accept Loads Into NYC?
Yes
No
Accept Mountain Routes?
Yes
No
Accept Port Loads?
Yes
No
Operate Nights?
Yes
No
Operate Weekends?
Yes
No
Accept Multi-Stop Loads?
Yes
No
Accept Partial Loads?
Accept
Refuse
Refused Brokers
Home Time Preference
Preferred Trip Length
Operating Hours
Preferred Pickup/Delivery Appointment Times
Uploads & Final Certification
Upload van photos
Upload a File
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Upload cargo area photos
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Upload additional documents
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Final accuracy confirmation signature
*
Date of certification
*
-
Month
-
Day
Year
Date
Submit
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