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Wisconsin Motor Carriers Association
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Driver of the Month Winner Information Sheet
DOM Information Sheet
Name
First
Last
Company
Spouse/Guest's Name
First
Last
Will you be attending the Annual Safety Awards Banquet at The Hotel Mead, Wisconsin Rapids on Saturday February 25, 2017.
Yes
No
Driver's Jacket Size
Small (Chest 47")
Medium (Chest 51")
Large (Chest 55")
XL Large (Chest 59")
2XL Large (Chest 63")
3XL Large (Chest 67")
4XL Large (Chest 71")
5XL Large (Chest 75")
First Name on Driver's Jacket Should Read:
Union Local # (If applicable):
Questionnaire
Number of Children
Number of Grandchildren
Type of vehicle used in dail work and type of commodities you usually haul:
What characteristics do you feel make up a safe truck driver?
Do you have a favorite hauling memory? Or a favorite area of the country you like driving through?
What is the most rewarding part of being a truck driver?
What hobbies, volunteer, and or community wrok do you enjoy taking part in?
What advice would you give to other drivers to ensure safe driving?
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