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Forms
Agency Application
Company Information
Agent of Record
:
Agency/Company_Name
:
Address
:
City
:
State
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ZipCode
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Physical Address
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City
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State
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ZipCode
:
Fed ID#
:
Contact Information
Phone #1 (800)
:
Phone (Local)
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Fax #
:
E-Mail Address
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Dispatcher(s)
:
Dispatch Phone #
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Dispatch E-mail
:
Personal Information
Home Address
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City
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State
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ZipCode
:
Home Phone #
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Birthdate
:
DL#
:
DL State
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List any current or prior agency affiliations that you wish to tell us about
:
What type of freight do you move
?
What type of equipment do you use most
?
How much freight do you broker
:
How much will you broker with Sargent Trucking
?
Where is your business going to be located
?
Home
Office Complex
What kind of internet connection do you have? (Dial-up, DSL, Cable, etc.)
What was your gross revenue last year
?
What is your current average gross profit margin (%)
?
What are you projecting your gross revenue will be if you were with Sargent Trucking
?
How many loads did you move last month
?
How many loads do you project you will move the first month with Sargent Trucking
?
Why are you interested in becoming a member of the Sargent Trucking team
?
What do you think we need to do as the parent company to make you successful in this new business venture
?
Submit automatically by email
I would like to print this application and mail it myself
