Information Request Form
Please fill in the details and then click the "Submit" button,
or print this form, and mail
the completed form to:
Mid-West Truckers Association, Inc.
2727 North Dirksen Parkway
Springfield, IL 62702
Workers
Compensation Insurance is now available
in 48 states!
Please check here for more information
Hospitalization Insurance & Prescription Drug Card
Please check here for more information
Safety Video Tape Lending Library
(For Members Only)
Video Training:
(Select the Video #'s that you are interested in)
| 109 110 111 112 113 115 116 117 120 126 127 |
| 128 129 131 133 134 136 137 139 141 143 144 |
| 146 151 152 153 157 158 161 162 166 185 186 |
| 187 |
Drug / Alcohol Training for Supervisors and drivers
Video Purchases
Intrastate Authorities
Select the States that you are interested in receiving Authorities
(select multiple states by using ctrl-Lclick)
Nationwide Random Drug / Alcohol Testing Program
Mr. Ms. Mrs. Miss
Name
Title
Company
Street Address
City
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Telephone
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Fax
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Email Address: