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45 Seconds to Pre-qualify

• First Name  
• Last Name  
• Postal Code  
• Email  
• Home Phone  
• Cell Phone  

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  Do you have a vaild Class 1/AZ Licence?

  Yes No

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  Number of Preventable Accidents last 3 years? 0 1 2 3 4 5

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  Number of Moving Violations last 3 years? 0 1 2 3 4 5

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  Do you have a TWIC card?

  Yes No

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  Do you have a fast card?

  Yes No

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  Have you ever been convicted of driving while intoxicated (DWI) or driving under the influence (DUI)?

  Yes No

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  Have you ever tested positive for Drug/Alcohol in the last 5 years?

  Yes No

• ---

  Are you able to cross the Canada/US border?

  Yes No
• Where did you hear about Searcy Trucking?  
• What types of equipment did you operate? (Dry Van, Flat, Step, etc.)