CARRIER PACKET Thank you for choosing SHALOM DISPATCH SERVICES. Please fill out the following information to the best of your ability. If the question does not apply to you please answer “N/A” in the blank space. Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Full Name *Date *Company Name or DBA *Phone # *Email Address *EmailConfirm EmailPreferred method of contact *PhoneEmailMC# *DOT# *What type of Trailer(s) do you have? (include dimensions & equipment you have) * Address you DOT# How many Trucks do you have? *Do you have a Factoring Company? *YesNoIf "NO", How do you intend to get paid?Factoring Company Name *Factroign Comapany Phone # *Driver(s) Name(s) *Preferred Geographical Lanes *Southern StatesWest Coast StatesMidWest StatesSouthEasthern StatesNorthEasthern StatesZones to AVOID *Zone 0Zone 1Zone 2Zone 3Zone 4Zone 5Zone 6Zone 7Zone 8Zone 9SUBMIT
