Drug and Alcohol Consortium Application

Drug and Alcohol Consortium Application
List Driver(s) First name, Last name *
Drivers CDL: *
DOB: *
Issuing State: *
Company Name: *
USDOT number: *
Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Mailing address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number: *

Area Code Phone Number
Email: *
example@example.com
Drivers Zip Code # : *
How did you hear about us? *

Online Truck Paper Other Referral
Please make your drivers aware that The Financial Integrity Group will be reaching out to them to set up their clearinghouse account.
Type a question

Type option 1 Type option 2 Type option 3 Type option 4
The Financial Integrity Group

410 East Taylor Street Suite G Griffin, GA 30223

authorities@tfig.org Fax: 770-228-4242
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