Thank you for your interest in becoming an approved carrier for Midwest Freight Services. We offer excellent opportunities for you to grow your business through competitive rates, prompt settlements and freight capacity. To get started, please fill out the Carrier Profile below.

MOTOR CARRIER PROFILE

MC#

DOT#

Federal Tax ID#

Legal Name

First Name

Last Name

DBA (If different from above)

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Ext.

Fax

Email Address

Dispatcher Name

First Name

Last Name

Dispatcher Phone

(###)

###

####

Dispatcher Ext.

Dispatcher

First Name

Last Name

Dispatcher Phone

(###)

###

####

Dispatcher Ext.

TWIC card drivers?

Yes

Driver advance is authorized?

Yes

Are you factoring your invoices?

Yes

CARGO INSURANCE

Company Name

Policy Number

Agent Name

First Name

Last Name

Agent Phone

(###)

###

####

Agent Ext.

Coverage Amount

LIABILITY INSURANCE

Company Name

Policy Number

Agent Name

First Name

Last Name

Agent Phone

(###)

###

####

Agent Ext.

Coverage Amount