Driver Entry Packet. Signature

Transcription

1 Iowa Truck Driving Championships Driver Entry Packet Participant Name Company Class of Competition Three-Axle Van Four-axle van Five-Axle Van Five-Axle Sleeper Five-axle flatbed Five-Axle Tank Truck Twin Trailers Straight Truck Two drivers per company, per terminal, per class are eligible to compete. For example, if you have one terminal in Iowa, you can have 16 drivers compete as long as you enter two drivers per class. Class changes cannot be made once this form is received by the IMTA office. Please be sure to check only one class. First time participant in Iowa Have you ever been a driver participant in the Iowa Truck Driving Championships? Yes No Payment Information $ Driver Entry Fee Includes one ticket to each meal provided, Facts for Drivers study book, commemorative arm patch and participation certificate. Refunds will not be issued after the May 16 entry packet deadline passes, no matter the circumstances. As stated in the eligibility rules, if a check is not available when driver entry packet is submitted, applications can be held with a credit card number until the check is received. Should a check still not be received the week prior to the event, the credit card number will be processed. Also, a driver and the company will be ruled ineligible to compete if an outstanding balance remains from the 2015 TDC. All items in this packet must be complete and accurate in order to be eligible to compete, and all eligibility rules must be met. If you have questions, contact Janelle Stevens by calling (515) or by ing janelle@iowamotortruck.com prior to submitting the completed packet. Check Payment Enclosed Payable to Iowa Council of Safety Management Check being processed Credit Card Number to Secure Driver Application only Process Credit Card Information Credit Card Number Expiration Date Security Code Billing Zip Code Name on Credit Card Signature Return Completed Forms & Payment Information To: Iowa Motor Truck Association 717 East Court Avenue Des Moines, IA (Fax) ( ) janelle@iowamotortruck.com

2 Thursday, June 16 Schedule of Events 11:00 AM Event Registration Desk Opens Hotel Lobby Lounge Area 11:30 AM TDC Class Coordinators & Committee Lunch Meeting Cafe at the Meadows 1:00 PM driver Team Building Activity Skinner Ballroom 2:30 PM driver Orientation Session Skinner Ballroom 3:00 PM personal Interview Judges Orientation Skinner Ballroom Atrium 3:30 PM driver Written Exam & Personal Interviews Skinner Ballroom 5:30 PM driver Staging for Parade of Champions Northeast Parking Lot 5:45 PM parade of Champions & Driver Appreciation BBQ Northeast Parking Lot 7:30 PM bike Roadeo Northeast Parking Lot [1st grade through 6th grade participants] 8:00 PM conclusion of Evening Activities Friday, June 17 7:00 AM breakfast Buffet & TDC Kick-Off Bishop Ballroom 8:30 AM TDC Volunteers Check-in & Orientation Northeast Parking Lot -- Volunteer Tent 8:30 AM estimated Beginning of Pre-Trip Testing & Driving Course Testing 11:30 AM Special Driving Challenge: CEO/Board Members 4:00 PM estimated Conclusion of Pre-Trip Testing & Driving Course Testing 6:00 PM driver Team Photos Begin Bishop Ballroom Atrium [Teams are assigned designated times ahead of time & will be sent in driver information packet.] 6:00 PM cocktail Reception Bishop Ballroom Atrium 7:00 PM banquet of Champions Bishop Ballroom

3 Hotel Accommodations Drivers, company representatives and all event guests are responsible for making their own hotel accommodations and paying for these accommodations. The driver entry fee does not include hotel accommodations. The Iowa Motor Truck Association strongly advises you to make your accommodations right now! This room block has been known to sell out within minutes. Also, please do not reserve more rooms than necessary out of fairness to other groups waiting to secure rooms at Prairie Meadows. Please note, cancellations on rooms secured under the room block affect the size of the hotel block for the following year s event. Prairie Meadows Hotel 1 Prairie Meadows Drive Altoona, IA Event Headquarters Hotel Room Block Dates: June 15-17, 2016 Room Block Rate: Starting at $ (excluding tax) Room Block Name: Iowa Motor Truck Association Reservations Phone Number: (800) Room Block Deadline: May 25, 2016 at 5:00 PM Hotel Check-In Time: 4:00 PM Hotel Check-Out Time: 11:00 AM Other local hotel options Once the reserved block of rooms at Prairie Meadows is completely sold out, drivers, company representatives and event guests are responsible for researching and making their own hotel accommodations. The Iowa Motor Truck Association staff is not able to assist with getting your group into Prairie Meadows, or any other local hotels. Other local hotel options are listed in this section; however, there are not room blocks established at the additional options, only at Prairie Meadows. Adventureland Inn Adventureland Drive Altoona, IA Motel Adventureland Drive Altoona, IA Best Western Plus th Avenue NW Altoona, IA Quality Inn & Suites Adventureland Drive Altoona, IA Holiday Inn Express Adventureland Drive NW Altoona, IA 50009

4 Eligibility Rules 1. The driver must regularly perform the duties of a professional truck driver. 2. The driver must have been employed continuously by the represented employer for 12 months prior to the State Truck Driving Championships. 3. The driver must have an accident-free record 12 months prior to entry in the State Truck Driving Championships. 4. The driver must meet all DOT physical requirements. 5. The driver must represent the state in which they reside or are domiciled. Domiciled means the reporting location where a driver reports for work, such as a home terminal, location of parking the truck, etc. 6. A driver must compete in a different class if they have taken first place in the same class for two consecutive years. 7. The driver must have not been disqualified for misconduct or other reasons within their company or at previous State Truck Driving Championships. 8. Two drivers per company/per terminal/per class are eligible to compete. For example, if you have one terminal in Iowa, you can have 16 drivers compete as long as you enter two drivers per class. There are eight classes of competition. 9. The driver entry fee of $200/driver must accompany the application in order for it to be considered complete. If a check is not yet available, applications can be held with a credit card number until the check is received. Should a check still not be received the week prior to the event, the credit card number will be processed. Driver materials will not be sent out until the completed forms and entry fee is received. Refunds will not be available after the May 16, 2016 entry packet deadline. 10. A driver and the company team will be ruled ineligible to compete if an outstanding balance remains from the previous years competition. 11. All submitted forms must be filled out completely and signed where necessary. 12. Drivers that place first in their class will not get an automatic seat on the Iowa Road Team. Instead, the first place winner will get an automatic nomination to interview for the opportunity to become an Iowa Road Team member. The first place driver s company must still submit a nomination packet in order to be eligible to interview. 13. In the event that a State Champion is unable to compete due to disqualification, ineligibility or personal reasons, the second place winner in the same class may compete in the ATA National Truck Driving Championships if they meet the appropriate qualifications. For the purpose of this rule, disqualifying acts are defined in Chapter V, Section L, Rules 16-18; acts or situations that render a State Champion are defined in Chapter V; and personal reasons are intended to include family emergencies, financial circumstances, and/ or a desire not to compete. For further clarification, in the cases of a State Champion who is a non-ata member and neither subparagraphs (a) nor (b) of Chapter V, Section A, Rule 1 apply, the second place winner in the same class may compete. To submit an eligibility appeal and receive a determination for the Entry and Eligibility Subcommittee, the entering employer must complete the official form (Appendix II) and send it to the ATA SMC as required under Chapter II, Rule 22. SOURCE: ATA State & National Rules & Procedures Booklet Questions about driver Eligibility rules? Call Don Egli at the IMTA office at (515)

5 Miscellaneous Driver Entry Fee The $ driver entry fee includes: one ticket to each meal provided at the event, Facts for Drivers study book, commemorative arm patch and participation certificate. Upon receiving the application and entry fee, the Iowa Motor Truck Association will send the individual signing off on the employer entry & release page the Facts for Drivers study book and the commemorative arm patch. This individual is then responsible for getting these two items to the registered driver. Questions for the written exam come from the Facts for Drivers book and from a question bank provided by the American Trucking Associations. Dress Code The only dress code that is required is that the drivers dress properly and professionally. Company uniforms are not required but are highly encouraged. Drivers are judged on a number of items and dress is one of those items. Remember, this event is highly visible and very representative of the industry. Our objective is to promote the professionalism that exists in the industry. Driver are true professionals and we encourage them to make an effort to dress that way. Cell Phone Policy Any participant caught using a cell phone during any of the four testing portions of the event will be automatically penalized with scoring deductions towards their team score. This includes the written exam, personal interviews, pre-trip inspection and driving skills tests. It is advised to leave cell phones in hotel rooms or personal vehicles during the event. The Iowa Motor Truck Association is not responsible for lost cell phones and will not place individuals in charge of making sure participants cell phones are kept secure. Equipment All equipment used in the competition is provided. Every effort is made to provide new equipment and to provide everyone a fair opportunity during their driving skills competition and pre-trip inspection. Courses All of the driving will be done on day two, on two courses. The committee chairman appoints two committee members to draw up four courses and submit those courses for review. The committee chairman then makes the final decision as to the final course layout two days prior to the event. Course layouts will not be provided prior to the event. Scoring Scores are final and tests scores are not publicly posted nor shared with anyone outside of the company of which the driver is employed. Safety directors receive the results of their specific drivers approximately 10 days following the event. Scores are not given out at the event. All of the scoring is professionally done through a computerized program overseen by an outside representative inputting and reviewing the information. Areas of Testing Written Exam Points Personal Interview Points Pre-Trip Inspection Points Driving Skills Test Points Weather The Truck Driving Championships are held rain or shine. The weather is a factor that a professional truck driver has to deal with on a daily basis. The driving portion of the event may have to be delayed or postponed if the safety of the volunteers, spectators or drivers is jeopardizes because of weather. The committee retains the right to change the schedule if weather problems arise during competition. Recruiting Recruiting of drivers is strictly prohibited. Any company representative that engages in recruiting will be asked to leave and if their company has a driver, or team, competing, they will be automatically disqualified. Conduct Professional conduct is required at all times and if any competing driver displays inappropriate conduct, he or she will be asked to leave the competition and future participation will be considered by the rules committee. Casino & Gambling Authority Policy Keep in mind that this event is held in, and on, casino property and all participants, and guests, are to abide by policies set in place by the racing & gambling authority. If you are not allowed to be on casino property, you are not allowed to take part in this event. Children under 18 are welcome if accompanied by an adult. However, no one under the age of 21 is allowed to access the casino floor, located on Level 2. Questions about driver Eligibility rules? Call Don Egli at the IMTA office at (515)

6 Employer Entry & Release Participant Name Company Class of Competition Three-Axle Van Four-axle van Five-Axle Van Five-Axle Sleeper Five-axle flatbed Five-Axle Tank Truck Twin Trailers Straight Truck Two drivers per company, per terminal, per class are eligible to compete. For example, if you have one terminal in Iowa, you can have 16 drivers compete as long as you enter two drivers per class. Class changes cannot be made once this form is received by the IMTA office. Please be sure to check only one class. Eligibility Rules 1. The driver must regularly perform the duties of a professional truck driver. 2. The driver must have been employed continuously by the represented employer for 12 months prior to the State Truck Driving Championships. 3. The driver must have an accident-free record 12 months prior to entry in the State Truck Driving Championships. 4. The driver must meet all DOT physical requirements. 5. The driver must represent the state in which they reside or are domiciled. Domiciled means the reporting location where a driver reports for work, such as a home terminal, location of parking the truck, etc. 6. A driver must compete in a different class if they have taken first place in the same class for two consecutive years. 7. The driver must have not been disqualified for misconduct or other reasons within their company or at previous State Truck Driving Championships. 8. Two drivers per company/per terminal/per class are eligible to compete. For example, if you have one terminal in Iowa, you can have 16 drivers compete as long as you enter two drivers per class. There are eight classes of competition. 9. The driver entry fee of $200/driver must accompany the application in order for it to be considered complete. If a check is not yet available, applications can be held with a credit card number until the check is received. Should a check still not be received the week prior to the event, the credit card number will be processed. Driver materials will not be sent out until the completed forms and entry fee is received. Refunds will not be available after the May 16, 2016 entry packet deadline. 10. A driver and the company team will be ruled ineligible to compete if an outstanding balance remains from the previous years competition. 11. All submitted forms must be filled out completely and signed where necessary. Certification by Employer I hereby certify that I am aware of the eligibility rules of the Iowa Motor Truck Association Truck Driving Championships, that the participant named is eligible to compete under these rules and that all information furnished about them is true to the best of my knowledge. Employer Printed Name: Employer Title: Employer Signature: Date: Mailing Address: City, State & Zip: Phone Number: ( ) Address:

7 Driver Entry & Release [Page 1 of 2] Participant Name Company Class of Competition First time participant in Iowa Have you ever been a driver participant in the Iowa Truck Driving Championships? Participant Information Yes No Participant Home Address: City, State & Zip: Phone Number: ( ) Address: Spouse Name: Children Name(s) & Age(s): Home Terminal Address: City, State & Zip: Phone Number: ( ) Supervisor Name: Length of Service with Current Company: Length of Service Overall in Trucking Industry: Number of Preventable Commercial Vehicle Accidents: Number of Non-Preventable Commercial Vehicle Accidents: Date of Last Commercial Vehicle Accident: Lifetime Safe Driving Miles:

8 Driver Entry & Release [Page 2 of 2] What Awards or acknowledgements (if any) have You received During Your Career? What is One Thing that You think of Every Time You Get into a Truck? How do you Professionally promote the trucking industry? Driver Agreement & Release: In consideration of my being permitted to participate in the Iowa Motor Truck Association s Truck Driving Championships and be eligible for awards offered to participants, I hereby stipulate and agree to the following: 1. Both as to myself and my heirs and personal representatives, I release IMTA, its directors, employees, agents and/or any of its affiliates from any and all liability and any right of action that may arise from any damage or injury I may receive while attending or participating in said Iowa Truck Driving Championships. 2. I will be bound to all orders, rules and regulations governing the Iowa Truck Driving Championships and/or its affiliates while participating in said competitions. Certification by Driver: I certify that during the past 12 months: 1. I have been continuously employed as a truck driver by my present employer; 2. I have not been involved in a disqualifying motor vehicle accident in the course of such employment; as per Section V, Paragraph 5 (SOURCE: ATA State & National Rules & Procedures Booklet); 3. I have the proper class Commercial Driver s License, plus required endorsement(s) for the class of competition indicated on entry packet; 4. I have resided or have been occupationally domiciled in the state of IOWA. I further certify that I have not received any form of pay, bonus, prize or any other consideration for time spent in practice as set forth in the Truck Driving Championships Rules & Procedures. I acknowledge that any misstatement made with respect to my eligibility for the Truck Driving Championships competition may result in the forfeiture of my right to compete, or in disqualification from the said competition. Participant Signature: date:

9 Course Announcer Sheet Participant Name Company Class of Competition First time participant in Iowa Have you ever been a driver participant in the Iowa Truck Driving Championships? Yes No If YES, how many years have you participated in the Iowa Truck Driving Championships? Approximately How many years have you been driving? Approximately How many miles have you driven during your career? What Made You Want to Become a professional truck driver? Name someone who has influenced you the most in your career? If You weren t driving a truck, what other job would you like to do? Tell us about you and your family (Spouse, Children, Grandchildren, hobbies, interests, etc.).

10 Meal Registration form Guest Name Company Guest or Family Member of a Driver Participant? Driver Name: IMPORTANT MEAL INFORMATION This form is for any individual planning to take part in the meals provided at the event. Drivers do not need to fill this form out for themselves since the meals are included with their entry fee. Meal tickets are required for all children and adults planning to eat. These meal tickets will need to be redeemed at the door of the banquet room or at the start of the buffet line, pending meal location. Meal registrations must be submitted prior to the event. Should you register for a meal on-site at the event, a 10% fee will be added to each meal ticket purchased. For the Banquet of Champions, with advance notice by May 16, we will try the best to accommodate vegetarian or gluten-fee dietary requirements; however, if you do not notify the IMTA office ahead of time we cannot guarantee being able to make these special accommodations. All other meals served will have vegetarian or gluten-free items available on the buffet. Meal refunds will not be available after May 16 no matter the circumstances. Payment Information Check Payment Enclosed Payable to Iowa Council of Safety Management Invoice Requested Process Credit Card Information Guest #1 First & Last Name: Driver Appreciation BBQ (Thursday Evening) --- $35.00 Breakfast Buffet (Friday Morning) --- $20.00 Banquet of Champions (Friday Evening) --- $55.00 Is this a child who is 10 and under? 25% discount Guest #2 First & Last Name: Driver Appreciation BBQ (Thursday Evening) --- $35.00 Breakfast Buffet (Friday Morning) --- $20.00 Banquet of Champions (Friday Evening) --- $55.00 Is this a child who is 10 and under? 25% discount Guest #3 First & Last Name: Driver Appreciation BBQ (Thursday Evening) --- $35.00 Breakfast Buffet (Friday Morning) --- $20.00 Banquet of Champions (Friday Evening) --- $55.00 Is this a child who is 10 and under? 25% discount Guest #4 First & Last Name: Driver Appreciation BBQ (Thursday Evening) --- $35.00 Breakfast Buffet (Friday Morning) --- $20.00 Banquet of Champions (Friday Evening) --- $55.00 Is this a child who is 10 and under? 25% discount Credit Card Number Expiration Date Security Code Billing Zip Code Name on Credit Card Signature Return Completed Forms & Payment Information To: Iowa Motor Truck Association 717 East Court Avenue Des Moines, IA (Fax) ( ) janelle@iowamotortruck.com

11 Event DVD Order Form We capture all of the event highlights from the entire event in one DVD and put it all together with music for an outstanding overview. The showing of this DVD has been the highlight of the Banquet of Champions year after year! This is a great opportunity to capture the excitement of the whole event. Order your unique souvenir of the 2016 Iowa Truck Driving Championships today. Orders will be accepted until Friday, June 24. Name: Company: Mailing Address: City, State & Zip: Phone Number: ( ) Address: Order Information Dvd Quantity x $15.00 = $ order TOTAL Payment Information Check Payment Enclosed Payable to Iowa Council of Safety Management Invoice Requested Process Credit Card Information Credit Card Number Expiration Date Security Code Billing Zip Code Name on Credit Card Signature Return Completed Forms & Payment Information To: Iowa Motor Truck Association 717 East Court Avenue Des Moines, IA (Fax) ( ) janelle@iowamotortruck.com