Contact Us today to start your future in Truck Driving!
(888) 565-0203
Contact Us!
(888) 565-0203
Serving Portland, Centralia, and Surrounding Areas
13691 NE Whitaker Way Portland OR 97230
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CDL Class A
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Enrollment
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
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Address
(Required)
Street Address
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City
State / Province / Region
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Email
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Phone
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If "Other" Please specify
Education
High School Diploma
Yes
No
GED
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No
Background Information
If accepted, can you provide proof that you are eligible to work in the United States?
Yes
No
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?
Yes
No
Have you ever been convicted of a misdemeanor?
Yes
No
Have you ever been convicted of a felony?
Yes
No
If YES Please specify
Are you currently on probation or parole?
Yes
No
Do you have ANY moving violations or accidents in the last 5 years?
Yes
No
Have you been convicted in the last 5 years of Reckless, Negligent, or Careless Driving?
Yes
No
Have you EVER been convicted for driving while intoxicated?
Yes
No
Have you ever had your driver's license suspended or revoked?
Yes
No
Do you have any history of epilepsy, diabetes, or high blood pressure?
Yes
No
Do you have any heart or cardiac problems?
Yes
No
Have you had any major surgeries, knee or back, or have other limitations?
Yes
No
Do you have any history of mental illness?
Yes
No
Do you have any history of dyslexia?
Yes
No
Do you have a poor work history or lack references?
Yes
No
Additional Information
Is there any other information that you would like to share with us about your interest in enrollment?
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