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First Name
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First Name
Last Name
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Last Name
Phone Number
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Phone Number
Email Address
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Email Address
How did you hear about us?
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How did you hear about us?
Do you have legal rights to work in the US?
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Do you have legal rights to work in the US?
Yes
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Current Address
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Current Address
Street Address
Address Line 2
City
State / Province / Region
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Virgin Islands, U.S.
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Country
Attach Resume
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Attach Resume
Drop files here or
Current Employer Information
If you aren't currently employed, please put your most recent employer information.
Are you currently employed?
*
Are you currently employed?
Yes
No
Employer Name
*
Employer Name
Reason for Leaving?
*
Reason for Leaving?
Employer Address
*
Employer Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Greenland
Grenada
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Saint Martin
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Sudan, South
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
Country
Experience
Are you currently acting as a broker or agent for another company?
*
Are you currently acting as a broker or agent for another company?
Yes
No
How many years of experience do you have as a freight broker or agent?
*
How many years of experience do you have as a freight broker or agent?
None - This is a career change
0-1
1-3
3-5
5+
What was your total gross sales revenue for the last year you were an agent?
*
What was your total gross sales revenue for the last year you were an agent? This number should reflect the most current full year of sales. If you are a new agent with no track record of sales, please put 0.
What was your profit margin for that same year?
What was your profit margin for that same year?
What methods do you use for finding new customers and new freight?
*
What methods do you use for finding new customers and new freight?
What commodities do you specialize in?
*
What commodities do you specialize in?
Are there any regions in the U.S. or internationally you specialize in?
*
Are there any regions in the U.S. or internationally you specialize in?
Are you under any restrictions currently, such as a non-compete?
*
Are you under any restrictions currently, such as a non-compete?
Yes
No
Do you have a current book of business you'll be bringing with you?
*
Do you have a current book of business you'll be bringing with you?
Yes
No
If yes, approximately how many customers?
If yes, approximately how many customers?
How familiar are you with the following?
Posting and searching on DAT
*
Posting and searching on DAT
No experience
Little experience (I have used it, but not much)
Some experience
A lot of experience - I don't need any training
Posting and searching on Internet Truckstop
*
Posting and searching on Internet Truckstop
No experience
Little experience (I have used it, but not much)
Some experience
A lot of experience - I don't need any training
How familiar are you with McLeod Trucking Software?
*
How familiar are you with McLeod Trucking Software?
No experience
Little experience (I have used it, but not much)
Some experience
A lot of experience - I don't need any training
How familiar are you with SharePoint?
*
How familiar are you with SharePoint?
No experience
Little experience (I have used it, but not much)
Some experience
A lot of experience - I don't need any training
Reference
Reference First Name
*
Reference First Name
Reference Last Name
*
Reference Last Name
How do you know this person?
*
How do you know this person?
Reference Phone Number
*
Reference Phone Number
Reference Email Address
*
Reference Email Address
How long have you known this person?
*
How long have you known this person?
Lastly, describe your ideal brokerage partnership.
*
Lastly, describe your ideal brokerage partnership.
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