Master Truck Driver Application

Qualifications

1. Driver must be nominated by an IMTA member Company
2. Driver must have driven for that company at least one year
3. Driver must have a clean Motor Vehicle Record for the past 3 years
4. Drive must have achieved either:
a) One million DOT preventable accident-free miles or
b) Ten years of DOT preventable accident free driving
5. The driver must have one of the following:
a) Completion of a Professional Driver Improvement Course
b) A record of community service
c) Participation in any Truck Driving Championships
d) Performance of an heroic act

Qualified Candidates Receive

Qualified Drivers will receive the following items, donated by Reliance Partners.

1 Master Truck Driver I.D. Card
1 Lapel Pin
1 Patch
1 Hat
2 Window Decal - one for each side of the truck
2 MTD Certificates (one for driver, one for company)
Presentation made by IMTA or member company
Press Release sent to driver's local paper and sent to Indiana House and Senate Representatives

Before starting application save a copy of the nominated driver's license and current MVR to upload during application process.

Driver Information

* Indicates required field

Driver Name *

First

Last

Driver's Phone Number *

License # *

Issuing State *

Home Address *

Line 1

Line 2

City

State

Zip Code

Country

Total Number of Years as a Driver *

No. of Years Crash-Free Driving *

Number of Crash-Free Miles *

# of Years with Nominating Company *

# of Years with Nominating Company as a Driver (Min. = 1 yr) *

Upload Driver MVR *

Max file size: 20MB

Driver MUST have completed at least ONE of the following options. Please indicate and describe answer below. *

Completion of a Professional Truck Driver Improvement Course (List Date Below) A Record of Community Service (List Examples Below) Participation in State Truck Driving Championships (List Date Below) Preformance of an heroic act (Describe Below)

Please elaborate on above checkbox answers: *

Supporting information for above checkboxes (optional) *

Max file size: 20MB

Driver's Hometown Newspaper *

Comment/Quote about the Driver to be Used in Press Release *

Nominating Company Name (This is the name that will be printed on Certificate, Wallet Card, and in Newspaper. PLEASE, write it out as you wish it to be seen.) *

Nominating Company Address *

Line 1

Line 2

City

State

Zip Code

Country

Nominator Name *

First

Last

Nominator Phone Number *

Nominator Email *

Submit