Monthly Registration – Bravo Compliance

Company Name*

DOT Number*

Name*

First Last

Phone Number*

Email Address*

Enter Email Confirm Email

Address*

Street Address City State ZIP Code

Password*

Enter Password Confirm Password

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Is owner also a CDL driver?*

Yes

Does your company have an Employee Assistant Program (EAP)?*

Yes

Driver's Information

Please enter driver's details below

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Driver's Name*

First Last

Driver's License Number*

Driver's License Issue Date*

Driver's License Expiration Date*

Class*

Driver's License State of Issue*

Endorsement*

Other Endorsement

Date of Birth*

Medical Certificate Expiration Date

Does the Owner/Operator have a DOT Pre-Employment Drug Test On File?*

Yes

A DOT pre-employment drug test with negative drug test results is required to be part of the Driver Qualification File (including owner/operators) for all DOT regulated companies. We can schedule this to be completed as part of your onboarding process if needed.