APPLICATION

* Please note that we are unable to provide assistance if the issue occurred while intoxicated, or under the influence of illegal drugs.

* We cannot help a misclassified driver seek employment to another 1099 misclassified driver job.

* We are not able to help with breakdown repairs.

Are you eligible to apply?

Do you have a valid Class A CDL?

Are you an over-the-road/regional semi-truck driver (not local)?

Do you have a medical problem?

(If this issue is related to a medical issue that first occurred within the last year you should apply for assistance with St. Christopher’s Fund – Truckers Relief Fund)

Please fill in ALL the fields below so we can contact you for follow up.

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    Applicants Name:

    Applicant's Information:

    Phone Numbers:

    Other Information: