Truck Driver Training Online Application

Please fill out all necessary information to enable us to serve you more effectively.*
Fields in red are required to be completed.

First Name: Last Name: Date of Birth (mm/dd/yy): Street Address: City: State: Zip Code: E-mail Address: Home Phone (incl. area code): Cell Phone (incl. area code): Driver's License #: Training Vehicle Desired: Class A   Class B Do you have a DOT physical? Yes   No Do you have a T.I.P. with air brake endorsement? Yes   No

Payment Method: Check   Credit Card If you selected "Credit Card" complete all information below: CREDIT CARD INFORMATION: VISA   Mastercard Cardholder's Name (as it appears on card): Account Number: Relationship: Expiration (mm/yy): Zip Code: Total Amount: $4695.00 Advanced Truck Driver Training Course (160 +/- hours) $2995.00 Accelerated CDL Class A Course (30 hours) $1450.00 Accelerated CDL Class B Course (8 hours) $775.00 CDL Refresher Course (4 hours) $2125.00 CDL Training Package E (20 hours) Total Payment: $ The student agrees that a 50% deposit is required 3 business days prior to the training date and is non-refundable. The student agrees that all remaining fees are payable, in full, by the training start date and are non-refundable. Tuition may be paid via cash, check, money order, Visa and MasterCard. In house accounts and financing are available for those who qualify. Prior to training, the Accelerated and Refresher course student must obtain a D.O.T. physical, Temporary Instructional Permit with appropriate endorsements, at their own expense. Room, board, transportation cost, to and from training site, is the responsibility of the student.

*We respect your privacy. Therefore, we will never sell, give, or otherwise provide your name, address, telephone number, or other information to anyone.