Enrollment | Western Pacific Truck School

Fill out the form below to get the enrollment process started. A training representative will get in touch with you as soon as possible.

Student Information

Name(Required)

First Last

Date of Birth

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email(Required)

Phone

How did you hear about us?

If "Other" Please specify

Education

High School Diploma

GED

Background Information

If accepted, can you provide proof that you are eligible to work in the United States?

Can you read and speak the English language sufficiently to converse with the general public, to understand highway traffic signs and signals in the English language, to respond to official inquiries, and to make entries on reports and records?

Have you ever been convicted of a misdemeanor?

Have you ever been convicted of a felony?

If YES Please specify

Are you currently on probation or parole?

Do you have ANY moving violations or accidents in the last 5 years?

Have you been convicted in the last 5 years of Reckless, Negligent, or Careless Driving?

Have you EVER been convicted for driving while intoxicated?

Have you ever had your driver's license suspended or revoked?

Do you have any history of epilepsy, diabetes, or high blood pressure?

Do you have any heart or cardiac problems?

Have you had any major surgeries, knee or back, or have other limitations?

Do you have any history of mental illness?

Do you have any history of dyslexia?

Do you have a poor work history or lack references?

Additional Information

Is there any other information that you would like to share with us about your interest in enrollment?

Monday	8:00am-4:30pm
Tuesday	8:00am-4:30pm
Wednesday	8:00am-4:30pm
Thursday	8:00am-4:30pm
Friday	8:00am-3:00pm