| City | Wellman |
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| State | Iowa |
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| What type of driver are you? | Independent |
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| What class is your commercial license? | Class A |
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| Select ALL types of driving you may want to do | Local, Regional |
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| Do you have a TWIC card? | No |
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| When did you start driving commercially? | 01/01/2015 |
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| How many accidents in last 3 years? | 0 |
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| How many moving violations in last 3 years? | 0 |
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| How many total commercial miles have you driven? | 1000000 |
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| What endorsements do you have? | Doubles/Triples, Tanker |
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| Years as a commercial driver | 9 |
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| Which days of the week do you plan to drive? | Monday, Tuesday, Wednesday, Thursday, Friday, Sunday |
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| How many hours per week do you plan to drive in the pool? | 70 |
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| When do you anticipate driving? | Morning / Afternoon |
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| Please select ALL that you would be willing to do | On Demand, Short Term, Long Term |
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| Do you currently belong to a consortium or are you in random drug pool? | Yes |
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| Select commodities where you have 6+ mo. experience (max 5) | Containers, Liquids/Gases, Intermodal Containers, Commodities Dry Bulk |
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| Do you plan to work outside of SlipSeat? | Yes, and it's a driving job |
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| How many hours per week do you anticipate working outside of SlipSeat? | 0 |
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| Do you have port experience? | Current |
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