Southern Iron Dispatch Intake

1
Primary contact full name* This field is required.
First Name
Middle Name
Last Name
2
Email address* This field is required.
example@example.com
3
Mobile phone number* This field is required.
Please enter a valid phone number.
4
Company legal name* This field is required.
5
Total trucks in fleet* This field is required.
6
Equipment/trailer types* This field is required.
Dry Van
Reefer
Flatbed
Step Deck
Box Truck
Power Only
Hot Shot
Tanker
Intermodal
Other
7
States or regions willing to operate* This field is required.
8
How soon are you looking to start dispatch services?* This field is required.
Immediately
Within 2 weeks
Within 30 days
Just exploring
9
Preferred loaded rate per mile* This field is required.
10
Minimum gross pay per load* This field is required.
11
Gross revenue goal per week* This field is required.
12
How many loaded miles would you prefer each load to have?* This field is required.
Under 250 miles
250–499 miles
500–749 miles
750–999 miles
1,000 or more miles
No preference
13
How many empty miles are you normally willing to drive to pick up a load?* This field is required.
Up to 25 miles
Up to 50 miles
Up to 100 miles
Up to 150 miles
More than 150 miles when the load pays enough
It depends on the load and total pay
14
When you give us your preferred rate per mile, is fuel already included?* This field is required.
Yes — my rate is all-in and already includes fuel
No — I expect fuel surcharge to be added separately
I am not sure — please review it with me
15
Which additional services are you willing and equipped to provide?* This field is required.
Driver assist — help load or unload freight
Tarping — cover and secure the load with tarps
Strapping — secure freight with straps
Chains and binders — secure heavy or flatbed freight
Load bars — stabilize freight inside the trailer
Multiple stops — complete more than one pickup or delivery
Inside delivery — move freight beyond the loading dock
None of these
It depends on the load and additional pay
16
Anything else we should know
17
Carrier Packet (Optional)
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