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Coeur D’Alene

By Andrew Horn | June 8, 2020

2201 N Government Way
Coeur D’Alene, ID 83814

1015 West Ironwood Drive
Coeur D’Alene, ID 83814

1200 W Ironwood Dr
Coeur D’Alene, ID 83814

5433 N Government Way
Coeur D Alene, ID 83815

5433 N Government Way
Coeur D’Alene, ID 83815

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DOT Consortium Program Enrollment Form

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Company Name:*
Step 1: Contact Information:
Contact Name:*
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Address 2:
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Company DOT Name:
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*
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- Company with 100 or more Drivers for a Stand-Alone Random Pool
Owner Operator:*
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Driver SSN or Employee ID:*
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* DOT pre-employment drug test must be completed before driver is added to random pool.

Step 2: Choose Enrollment Package:
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- Basic Package ($100)
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  - Part 40.25 Form (Required for all drivers)
Optional Add On
*
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- Part 40.25 Form ($25)
- Supervisor Training ($50/each)
- Paper Copies of 49 CFR Part 40 & 382 ($25)
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- No Additional Add-Ons = $0.00
All fees must be remitted with this form.
Add all columns on front and back on this form.
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