Shipper Advertising Form Requesting Freight Rates



P/U DATE:    LOADING TIME:    FREQUENCY:

TYPE of Posting or Ad:                                                                         Payment Terms-30 days maximum
                                

FROM STATE:      FROM CITY:   

     TO STATE:           TO CITY:   

Pay/Freight Rate/Freight Rate Desired       Mileage rate:
 
           

EQUIPMENT                                     FLEET SIZE-NUMBER OF TRUCKS
                   

COMPANY                                                            DISPATCH CONTACT
          

PHONE                                         E-MAIL                                            FAX
              

SALES CONTACT for shippers to call for freight rates:
 

Post an ad to promote your trucking business or brokerage services:
 

STATES OR PROVINCES YOU WANT FREIGHT or TRUCKS FROM ON A REGULAR BASIS:
 

STATES OR PROVINCES YOU WANT FREIGHT or TRUCKS TO ON A REGULAR BASIS:
 

Do you plan on hiring anyone in the next 12 months in any of the categories below?...
HIRING DRIVERS?    HIRING DISPATCHERS?    HIRING SALESPEOPLE?        RECRUITING Owner Operators?      RECRUITING AGENTS 

   
                                                                                                                 

HELP WANTED AD
 


Optional Section-Please tell us if you are planning a purchase of any of the products/services below within the next 24 months....

PURCHASE TRUCK                         PURCHASE SOFTWARE                PURCHASE INSURANCE/PRODUCTS/SERVICES
        
             

ADDRESS-Optional                                     CITY-Optional                                       STATE-Optional                ZIP/POSTAL CODE-Optional
 
                
         

TOLL FREE-Optional            WEBSITE-Optional
 
         

SUBSCRIBER: