Please complete the form below. Your responses are completely confidential. We will evaluate your information and contact you to discuss our analysis of the benefit your company can achieve by participating in the FMA process.

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* 1. Primary Contact for the FreightMath Assessment

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* 2. Carrier Name and SCAC

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* 3. Carrier Address

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* 4. Carrier Capacity (# of Trucks)

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* 5. Modes of Operation (Check all that apply)

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* 6. Brief Description of Carrier, Services, and Geographic Footprint

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* 7. Brief Description of Current or Past Freight Network Management

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* 8. Transportation Management System (TMS)

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* 9. TMS Data Contact - KSMTA requires certain load level operational data from your Transportation Management System (TMS). Please authorize KSMTA and/or its authorized representatives to contact the name provided below to access your TMS and extract the required data. (All data is protected by the NDA between KSMTA and your Company.)

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* 10. Financial Data Contact - KSMTA requires certain financial information (Trial Balances, Financial Statements, Driver Pay information, Miles, etc). Please authorize KSMTA to contact the name provided below to provide and discuss the required financial information. (All data is protected by the NDA between KSMTA and your Company.)

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* 11. Comments - Please include any other information we should be aware of regarding the structure of your business.

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* 12. Accept Terms and Conditions.

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* 13. Please add me to the KSMTA email list.

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