866-260-6116

Enterprise Truck Line Forms

To apply at Enterprise Truck Line the Owner/Operator Pre-Qualification Form and Permission Form must be filled out and submitted.

Owner/Operator Pre-Qualification Form can be filled out using the online version found here or using the PDF version that can be printed to fill out then submit either by mail, fax, or scanned to a computer then sent by email as long it is legible.

Permission Form is available only in PDF version that can be printed to fill out then submit either by mail, fax, or scanned to a computer then sent by email as long it is legible.

For mailing forms send it to:

  • Enterprise Truck Line
  • 9148 Louisiana St. Unit D
  • Merrillville, IN 46410

For faxing forms send it to:

  • 219-736-9201

For emailing the scanned in filled out form send it to:

  • chuck@entp.net

Page 1 of 4

Pre-Qualification Form

Online Owner/Operator Pre-Qualification Form

Full Name:(*)
Invalid Input

Address:(*)
Invalid Input

City:(*)
Invalid Input

State:(*)
Invalid Input

Zip Code:(*)
Invalid Input

Home Phone:(*)
Invalid Input

Cell Phone:(*)
Invalid Input

Email:(*)
Invalid Input

Date of Birth:(*)
/ / Invalid Input

Social Security #:(*)
Invalid Input

CDL License

Number:(*)
Invalid Input

State:(*)
Invalid Input

Expiration Date:(*)
/ Invalid Input

Education

Elementary/High School:(*)
Invalid Input

College:
Invalid Input

More:
Invalid Input

Do you have a high school diploma?(*)
Invalid Input

U.S. Armed Forces

Have you ever served in the U.S. Armed Forces?(*)
Invalid Input

Branch:
Invalid Input

Date Discharged:
/ Invalid Input

Rank at time of discharge:
Invalid Input

 

Safety Record

I certify that the following is a true and complete list of traffic violations (other than parking) for the past 5 years.

Traffic Violation 1

Date:
/ / Invalid Input

Location:
Invalid Input

Type of Offense:
Invalid Input

Type of Vehicle Operated:
Invalid Input

Traffic Violation 2

Date:
/ / Invalid Input

Location:
Invalid Input

Type of Offense:
Invalid Input

Type of Vehicle Operated:
Invalid Input

Traffic Violation 3

Date:
/ / Invalid Input

Location:
Invalid Input

Type of Offense:
Invalid Input

Type of Vehicle Operated:
Invalid Input

Please check this box if you do not have any traffic violations
Invalid Input

Note:

If NO VIOLATIONS are listed above, I certify that I have not been convicted or forfeited bond on any violation required to be listed during the past 5 years.

# of Moving Violations in last 5 years:(*)
Invalid Input

# of Accidents in last 5 years:(*)
Invalid Input

Failed/Refused a drug test?(*)
Invalid Input

Failed/Refused an alcohol test?(*)
Invalid Input

Are you currently on probation or parole?(*)
Invalid Input

DUI/DWI:(*)
Invalid Input

Have any license, permit, or privilege ever been suspended or revoked?(*)
Invalid Input

Convicted or charges pending for:

Misdemeanor:(*)
Invalid Input

Felony:(*)
Invalid Input

If yes, when?
/ / Invalid Input

Please Explain:
Invalid Input

 

Accidents

# of Accidents in last 5 years:(*)
Invalid Input

Please explain below.

Accident 1

Date:
/ Invalid Input

Type of Vehicle: (Tractor, Car, Motorcycle Etc.)
Invalid Input

Were you at fault?
Invalid Input

Were you ticketed?
Invalid Input

# of Fatalities:
Invalid Input

# of Injuries:
Invalid Input

Cost of Damage:
Invalid Input

Nature of Accident (Jackknife, Head-on, Rear End) and what happened?
Invalid Input

Accident 2

Date:
/ Invalid Input

Type of Vehicle: (Tractor, Car, Motorcycle Etc.)
Invalid Input

Were you at fault?
Invalid Input

Were you ticketed?
Invalid Input

# of Fatalities:
Invalid Input

# of Injuries:
Invalid Input

Cost of Damage:
Invalid Input

Nature of Accident (Jackknife, Head-on, Rear End) and what happened?
Invalid Input

Accident 3

Date:
/ Invalid Input

Type of Vehicle: (Tractor, Car, Motorcycle Etc.)
Invalid Input

Were you at fault?
Invalid Input

Were you ticketed?
Invalid Input

# of Fatalities:
Invalid Input

# of Injuries:
Invalid Input

Cost of Damage:
Invalid Input

Nature of Accident (Jackknife, Head-on, Rear End) and what happened?
Invalid Input

 

Please Read, Check Box, and Enter Security Code before Submitting

I certify that I personally completed this Pre-Qual Form and that all information is true and correct. I authorize Enterprise Truck Line to conduct a complete investigation of my background, including but not limited to all information from previous employer, or their agents to release information concerning any of my past controlled substance tests, employment and training records and hold them harmless from release of said information. I understand that false or misleading information will disqualify me from further consideration.

If you agree, please indicate your signature in the checkbox below.(*)
Invalid Input

Please enter the Security Code:(*)
Please enter the Security Code:
Invalid Input

Submit