DESCRIPTION OF REGISTRATION PROCESS:

  1. Fill out and submit form.
  2. A CarrierPoint representative will contact you to collect $95, payable by credit card.
   This $95 fee covers your on-line training session and first year of membership.
  3. Our training department will contact you to schedule on-line training.

  4. Log in and start using the system.

 

Fill out this application form and click the "Submit" button

Note: Required fields are denoted with an asterisk (*).

Acceptance of the Carrier Membership Application by CarrierPoint is subject to CarrierPoint determining, in its sole discretion, that the following Carrier membership qualification criteria are satisfied:

  1. Carrier must have a valid motor carrier registration number (ICC, DOT) that is consistent with the information on Carrier's on-line registration information.
  2. Carrier must have a "satisfactory" DOT safety rating, or, in the absence of any rating, no rating of "conditional" or "unsatisfactory".
  3. Carrier must have insurance coverages that meet regulatory requirements for general and automotive liability and cargo liability (loss and/or damage).
  4. Completion of a satisfactory credit check.
Which Shipper are you registering on behalf of?*
Which location of this shipper are you registering on behalf of (city, state)?*
* You MUST supply at least one city/state or your registration will be delayed.  
Who is your contact at the shipper location (first, last name)?*
 
Company Information
Company Name*
Physical Address (No P.O. Boxes)*
Suite, Bldg or Additional Information
City, State Zip*
Province (If applicable)
Country (If other than U.S.)
Main Phone Number*
(Example: 555-555-5555)
Main Fax Number*
Tax ID Number*
DOT #
Motor Carrier #*
Standard Carrier Alpha Code (SCAC)
Insurance Carrier
Policy Number
Expiration Date
Billing Information
Billing Contact Name
Billing Address (if different from above)
Suite, Bldg or Additional Information
City, State Zip
Province (If applicable)
Country (If other than U.S.)
Billing Phone Number
Billing Fax Number
Contact Information
(The person who will be the liaison to CarrierPoint.)
Contact Name*
Contact Email Address*
Title*
Additional Information
 (To help us better assist you)
CarrierType: Private   Commercial
Number of Trucks:
Dry Van: Flatbed: Refrigerated: Tanker:
Other:      
How many Power Units does your company use?
Is your company a property broker as defined by the ICC? Yes No
Are you qualified to transport hazardous materials? Yes   No
Commodities Targeted:
Additional Comments or Questions: