Driver of the Month Application

The selection committee evaluates drivers using a point system based on years of driving, career miles/hours, participation in events, community service, certifications, continued education programs, heroic acts and if applicable, preventable accidents and citations. Company and driver names are held in confidence to ensure fairness and equality.

Nomination Qualifications:
1. Only Drivers employed by an IMTA member company are eligible.
2. Drivers must be domiciled or live in Indiana.
3. All drivers must be non-preventable crash-free for the past year.
4. A copy of the BMV record and Driver’s License must be attached.
5. All fields MUST be completed.
6. Applications are due by January 1, 2021.
7. Nominated drivers must attend the awards banquet to be eligible.

* Indicates required field

Nominator Name *

First

Last

Nominator Email *

Nominator Phone Number *

Nominator Company *

Nominator Company Address *

Line 1

Line 2

City

State

Zip Code

Country

Driver Information

Only report individual driver miles, no team miles will be accepted.

Nominee Name *

First

Last

Hire Date with Nominating Company *

Domicile Terminal Location (City, State) *

# Years as a Driver *

Local Driver: Career Hours *

Over the Road Career Miles: *

License # *

Licensing State *

Date of Birth *

Home Address *

Line 1

Line 2

City

State

Zip Code

Country

Spouse's Name *

First

Last

List children & ages (if not applicable put N/A) *

Accidents & Citations

Miles Driven since last accident *

# of Preventable Accidents *

# of Non-Preventable Accidents *

Provide detailed information on all accidents: *

List Dates and Offenses for ALL Traffic Citations in the Past 7 Years:

Moving Citations for past 7 years: *

Non-Moving Citations for past 7 years; *

Biographical information

It is imperative that you include as much detail in this section as possible. We have the best drivers in the nation and the selection process gets very detailed. Include all heroic acts, special awards or recognition, clubs, organizations, church activities, involvement in community, hobbies, etc. Supply as much information as possible.

Driver is an Indiana Master Truck Driver *

Yes No Unknown

Driver has taken a PDIC Course *

Yes No Unknown

# Years involved in Truck Driving Championships *

Describe Driver's History of Community Service *

List any Heroic Acts the driver has performed *

Walk Up Song Title & Artist: *

Submit