Student Application

CDL TRAINING ENROLLMENT APPLICATION

CDL Training Admission Requirements

Must be 18 years of age or older
Hold a valid driver's license within the U.S.
Have a valid DOT Medical Examiners Certificate
Must obtain an MVR confirming validity of current Driver's License
Must be able to take and pass a DOT urine drug test (this is done prior training start date)
Understand highway traffic signals and signs
Have basic fundamental skills to read, write and speak English, as per Federal Motor Carrier Safety

Regulations.(391 FMCSR)

Please select the type of Training you are applying for:

Class A Training Class B Training

Personal Information:

First Name

Last Name

Middle Name

Suffix

Last 4 digits of SSN

Date of birth

Select Your Sex

Male Female

Personal Contact Information:

Cell number

Email address

Emergency Contact Information:

Name

Relationship to you

Cell number

Address Information:

Home Address

City

State

Zip

Drivers licence Information:

Licence number

State Issued

Expiration date

Do you currently posses a Commercial Learner's Permit? If yes, please provide us with the following info:

Restrictions/Disqualifications

Class

Expiration date

Is your license currently suspended or revoked?

Yes No

MEDICAL CERTIFICATE INFORMATION

Certification Date

Expiration Date

Do you take any medication that might affect your ability to safely operate a commercial motor vehicle?

Yes No

PAYMENT METHOD

We accept checks, money orders and credit card payments.
If paying by check or money order, please make them payable to Carolina CDL Training Center, Inc.

Do you neede lodging during your training? (available for an additional charge)

Yes No