Client Application Form FR Client Application Form Thank you for connecting with us. We will respond to you shortly. 11 falsemessagehttps://dlvrdfreight.com/application/wp-admin/admin-ajax.phphttps://dlvrdfreight.com/applicationyes 1 fadeInfadeOut Billing InformationLegal Name of CompanyDBA Name if different from above Contact Name Role AddressCityProvince / State--- Select ------ Provinces ---AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon--- States ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingPostal / Zip Code *Phone Number Extension *EmailCurrencyCADUSDBoth Invoicing Contact Contact Name Role *Phone Number Extension *EmailAdd another invoicing contact?YesNo Invoicing Contact #2 Contact Name Role *Phone Number Extension *Email Add another billing contact?YesNo Billing Contact #2 Contact Name Role *Phone Number Extension *Email Back Next Operation / Traffic Contact Contact Name Role *Phone Number Extension *EmailAdd another operation / traffic contact?YesNo Operation / Traffic Contact #2 Contact Name Role *Phone Number Extension *Email Back Next Does your company ship cross-border?YesNo Canadian Customs Broker *Company Name Contact Name Role Phone Number Extension EmailAdd another contact?YesNoUS Customs BrokerDo not have oneSame as Canadian Customs BrokerDifferent than Canadian Customs Broker Canadian Contact #2 Contact Name Role Phone Number Extension Email US Customs Broker *Company Name Contact Name Role Phone Number Extension EmailAdd another contact?YesNo US Contact #2 Contact Name Role Phone Number Extension Email Back Next Shipper / Consignee LocationIs the shipper / consignee location different than the bill to company?YesNoName of the company to or from which most of your freight ships Contact Name Role *Phone Number Extension *EmailHours of Operation Same dailyVariable schedule Please enter using military time (00:00) Opening Time Closing Time Closed for lunch?YesNo From To Please enter using military time (00:00) MondayOpening TimeClosing TimeTuesdayOpening TimeClosing TimeWednesdayOpening TimeClosing TimeThursdayOpening TimeClosing TimeFridayOpening TimeClosing TimeSaturdayOpening TimeClosing TimeSundayOpening TimeClosing TimeClosed for lunch?YesNo From To Does the location have a dock?YesNoWhat is the largest truck/trailer the location can accomodate?--- Select ---Truck with sleeper & 53-foot trailerDaycab truck with 53-foot trailer26-foot straight truck24-foot straight truck20-foot straight truck Is a lift gate required?Yes NoDoes the location have a forklift?YesNoDoes the driver require a pallet jack?YesNoWould you like to add another shipper / consignee location?YesNo Shipper / Consignee Location #2 Company Name Contact Name Role *Phone Number Extension *EmailHours of Operation Same dailyVariable schedule Please enter using military time (00:00) Opening Time Closing Time Closed for lunch?YesNo From To Please enter using military time (00:00) MondayOpening TimeClosing TimeTuesdayOpening TimeClosing TimeWednesdayOpening TimeClosing TimeThursdayOpening TimeClosing TimeFridayOpening TimeClosing TimeSaturdayOpening TimeClosing TimeSundayOpening TimeClosing TimeClosed for lunch?YesNo From To Does the location have a dock?YesNoWhat is the largest truck/trailer the location can accomodate?--- Select ---Truck with sleeper & 53-foot trailerDaycab truck with 53-foot trailer26-foot straight truck24-foot straight truck20-foot straight truck Is a lift gate required?Yes NoDoes the location have a forklift?YesNoDoes the driver require a pallet jack?YesNo Back Next CommodityPlease provide a detailed descriptionNMFC Field (Optional)Class Field (Optional)Type of packaging--- Select ---BaleBarrellBoxesCrateFloor loadedPallet (Exposed)Pallet (Shrinkwrapped)Sheets Tubes Size LengthFixed VariableLength (Inches) Minimum Length (Inches) Maximum Length (Inches) WidthFixed VariableWidth (Inches) Minimum Width (Inches) Maximum Width (Inches) HeightFixedVariableHeight (Inches) Minimum Height (Inches) Maximum Height (Inches) WeightFixedVariableWeight (LBS) Minimum Weight (LBS) Maximum Weight (LBS) Upload image of freight (optional) doc docx mpg mpeg mp3 mp4 odt odp ods pdf ppt pptx txt xls xlsx jpg jpeg png psd tif tiff Add another commodity?YesNo Commodity #2 Please provide a detailed descriptionNMFC Field (Optional)Class Field (Optional)Type of packaging--- Select ---BaleBarrellBoxesCrateFloor loadedPallet (Exposed)Pallet (Shrinkwrapped)Sheets Tubes Size LengthFixed VariableLength (Inches) Minimum Length (Inches) Maximum Length (Inches) WidthFixed VariableWidth (Inches) Minimum Width (Inches) Maximum Width (Inches) HeightFixedVariableHeight (Inches) Minimum Height (Inches) Maximum Height (Inches) WeightFixedVariableWeight (LBS) Minimum Weight (LBS) Maximum Weight (LBS) Upload image of freight (optional) doc docx mpg mpeg mp3 mp4 odt odp ods pdf ppt pptx txt xls xlsx jpg jpeg png psd tif tiff Back Next In an effort to better serve you or if you wish to use our customer portal for order entry, please supply the locations from which you ship to on a regular basis using the following template.Download template Upload File (*.xls or *.xlsx) xls xlsx Back Next Please note that PODs are available on request. We gather a proof of delivery for every single shipment we move. We would appreciate the opportunity to bill you at time of delivery. I do not need a POD to receive an invoice Back Next Would you like to submit a trade reference?YesNo Trade Reference #1 Company Name *Phone Number Extension Would you like to submit another trade reference?YesNo Trade Reference #2 Company Name *Phone Number Extension Would you like to submit another trade reference?YesNo Trade Reference #3 Company Name *Phone Number Extension Back Submit