Subscribe to Driver Report

I wish to subscribe to the driver monitoring service, DriverReport.com.

Company

Name

Title

Mailing Address

City

State

Zip Code

E-mail

Phone

Fax

Cost of Annual Service:

	# of Vehicles		Annual Fee
10-100 Vehicles		x $19.00 =
101-500 Vehicles		x $17.00 =
501-1000 Vehicles		x $15.00 =
1001-1500 Vehicles		x $13.00 =
Over 1500 Vehicles		x $11.00 =

Please input P.O. number (if available)

How did you learn first about DriverReport.com?
Truckline.com Web Ad (American Trucking Associations)

Truck.net Web Ad

Direct Mail from DriverReport.com

Utility Fleet Management Print Ad

Heavy Duty Trucking Print Ad

Trade Association / Convention

Insurance Company

Word of Mouth

DriverReport.com will provide a monitoring service for all registered vehicles with the above fleet. DriverReport.com will provide decals for each vehicle covered (one license plate sized with the web address and toll-free number, a second smaller decal with vehicle identification number). Individuals will then use the on-line or toll-free reporting methods to submit incidents involving this company's drivers. A detailed report will be faxed to the above company by DriverReport.com for each incident.

On a monthly basis DriverReport.com will provide a comprehensive summary of the previous month's data, including all incident follow up received from the company.

Monitoring service is on an annual basis and may be canceled at any yearly interval without penalty. Upon receipt of application, confirmation letter and contract will be mailed. Decals will be mailed after receipt of annual fee.