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Pre-Qualification Form
  1. Online Owner/Operator Pre-Qualification Form

  2. Full Name:(*)
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  3. Address:(*)
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  4. City:(*)
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  5. State:(*)
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  6. Zip Code:(*)
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  7. Home Phone:(*)
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  8. Cell Phone:(*)
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  9. Email:(*)
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  10. Date of Birth:(*)
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  11. Social Security #:(*)
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  12. CDL License

  13. Number:(*)
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  14. State:(*)
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  15. Expiration Date:(*)
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  16. Education

  17. Elementary/High School:(*)
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  18. College:
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  19. More:
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  20. Do you have a high school diploma?(*)
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  21. U.S. Armed Forces

  22. Have you ever served in the U.S. Armed Forces?(*)
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  23. Branch:
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  24. Date Discharged:
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  25. Rank at time of discharge:
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  1. Safety Record

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

  2. Traffic Violation 1

  3. Date:
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  4. Location:
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  5. Type of Offense:
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  6. Type of Vehicle Operated:
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  7. Traffic Violation 2

  8. Date:
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  9. Location:
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  10. Type of Offense:
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  11. Type of Vehicle Operated:
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  12. Traffic Violation 3

  13. Date:
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  14. Location:
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  15. Type of Offense:
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  16. Type of Vehicle Operated:
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  17. Please check this box if you do not have any traffic violations
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  18. 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.

  19. # of Moving Violations in last 5 years:(*)
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  20. # of Accidents in last 5 years:(*)
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  21. Failed/Refused a drug test?(*)
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  22. Failed/Refused an alcohol test?(*)
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  23. Are you currently on probation or parole?(*)
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  24. DUI/DWI:(*)
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  25. Have any license, permit, or privilege ever been suspended or revoked?(*)
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  26. Convicted or charges pending for:

  27. Misdemeanor:(*)
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  28. Felony:(*)
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  29. If yes, when?
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  30. Please Explain:
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  1. Accidents

  2. # of Accidents in last 5 years:(*)
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  3. Please explain below.
  4. Accident 1

  5. Date:
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  6. Type of Vehicle: (Tractor, Car, Motorcycle Etc.)
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  7. Were you at fault?
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  8. Were you ticketed?
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  9. # of Fatalities:
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  10. # of Injuries:
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  11. Cost of Damage:
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  12. Nature of Accident (Jackknife, Head-on, Rear End) and what happened?
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  13. Accident 2

  14. Date:
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  15. Type of Vehicle: (Tractor, Car, Motorcycle Etc.)
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  16. Were you at fault?
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  17. Were you ticketed?
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  18. # of Fatalities:
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  19. # of Injuries:
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  20. Cost of Damage:
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  21. Nature of Accident (Jackknife, Head-on, Rear End) and what happened?
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  22. Accident 3

  23. Date:
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  24. Type of Vehicle: (Tractor, Car, Motorcycle Etc.)
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  25. Were you at fault?
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  26. Were you ticketed?
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  27. # of Fatalities:
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  28. # of Injuries:
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  29. Cost of Damage:
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  30. Nature of Accident (Jackknife, Head-on, Rear End) and what happened?
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  1. 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.

  2. If you agree, please indicate your signature in the checkbox below.
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  3. Please enter the Security Code:(*)
    Please enter the Security Code:
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  4. Submit