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2010 DRIVER OF THE YEAR APPLICATION
This honor is awarded to the NJWMA professional driver (local & long distance) displaying the highest degree of professionalism, safety and courtesy in performing their job and representing the moving industry.
Driver’s Name: ___________________________________________ Date of Birth: ________________________
Address: _________________________________________________ Home Phone # _______________________
Street City State/Zip
Employer: ________________________________________________ Driver’s Home Terminal: _______________
Company President/Owner: __________________________________ Terminal Manager: ____________________
Employer’s Main Address: _______________________________________________________________________
Street City State/Zip
Type of equipment regularly operated: ____ Straight Truck _____ Tractor /Trailer _____ Both _____ City/Local _____ Long Distance
Normal driving run: From _______________________________________ To ________________________________
Years of commercial driving: Present Employer All Past Employers
*Mileage ________________________ ____________________________
*Hours of service ________________________ ____________________________
Accidents: ________________________ ____________________________
Preventable: ________________________ ____________________________
Non-Preventable: ________________________ ____________________________
Date of Last Accident: _________________ Preventable _____________ Non-Preventable ________________
*City/local operations compute hours of service, long distance compute mileage. Include both if known.
Based upon standard of 2,500 hours equals 100,000 miles.
Biographical Sketch (Attach separate sheet): Nomination will be based on: (a) years of safe
professional driving, (b) deed(s) of heroism, or (c) outstanding act(s) of courtesy on the road. Include all
pertinent information. The following are suggested additional areas to include in the biographical sketch:
Names and length of service with previous employers, awards received as a professional driver, rodeo
competition, courses of school attended, membership (civic, fraternal groups, church, fire department,
scouts, etc.), and other activities and hobbies. Please submit a copy of the driver’s license with the application.
PERSON SUBMITTING ENTRY FORM & MEMBER COMPANY:
_____________________________________________________________________________________________
Name Company/ Title Date
Address: _______________________________________________ Phone # _______________________________
Return to: SAFETY COMMITTEE
c/o New Jersey Warehousemen & Movers Association
94 E. Water Street
Toms River, NJ 08753-7507
Phone: 732-341-3934 Fax: 732-341-5687
APPLICATION DEADLINE: SEPTEMBER 1, 2010
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