DISPATCHER AGREEMENT Company Name*Motor Carrier #*Dot #*Number of trucks*Authority Start Date* MM slash DD slash YYYY Trailer TypeDry VansFlatbedsHot ShotsReefersTrailer TypeDry VansFlatbedsHot ShotsReefersDesired Region(s)* 48 States Southeast Southwest Northeast Midwest West Coast Driver Home Time* Every Other Day Every Weekend Every Two Weeks Flexible Do you have any FreightGuard Reports? (copy)* Yes No If you answered yes, explain.Desired Weekly Gross AmountIs there a tracking device in the truck?* Yes No Name* First Last TitleEmail Address* Phone*ExtensionWhat is the best time of day to contact you?*Signature*
