qualification

TO BECOME ALIGNED FOR DESIGNATED AND/OR ONE-TIME LOADS, PLEASE SUBMIT THE APPLICATION BELOW. ONCE YOU HAVE CHECKED TO BE SURE ALL OF YOUR INFORMATION IS CORRECT, CLICK ON THE “SUBMIT” BUTTON AND YOUR APPLICATION WILL GO DIRECTLY TO SKYLINE LOGISTICS, LTD. ONCE WE VERIFY ALL YOUR INFORMATION, YOU WILL BE CONTACTED WITH THE RESULTS OF YOUR APPLICATION.
Date :  (ex. 1999) 
NAME :
DBA :
PHYSICAL ADDRESS :
MAILING ADDRESS :
EMAIL ADDRESS :
PHONE NUMBER : FAX NUMBER:
TOLL FREE NUMBER : AFTER-HOURS NUMBER :
NUMBER OF TRACTOR/TRAILERS THAT CAN BE USED :
NUMBER OF REEFERS :
NUMBER OF FLATBEDS :
NUMBER OF UNITS OWNED :
NUMBER OF OWNER/OPERATOR UNITS :
ARE YOU ALSO A BROKER? : UNDER WHAT NAME?
AUTHORITY MC# YEARS IN BUSINESS IN BUSINESS SINCE
PRINCIPAL OWNER :
INSURANCE COMPANY :
AGENT :
AMOUNT OF AUTO LIABILITY :
AMOUNT OF MOTOR TRUCK CARGO : DEDUCTIBLE :
REEFER COVERAGE :          DEDUCTIBLE :
   
COMPANY REFERENCES:  
1:
2:
3:
   
BANKING INFORMATION :  
NAME OF BANK :
LOCATION :
   
NAME OF PERSON COMPLETING FORM :
PHONE NUMBER :
Skyline Logistics Ltd. (C) 2005