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Thank you for your interest in partnering with MDS as an Independent Contractor. Contractor qualification is established by Federal, State and Local laws (I.e. US Department of Transportation) and MDS customer requirements. The Independent Contractor preliminary application will be reviewed and a MDS representative will contact you if you satisfy specific requirements.
Personal Information
First Name: Last Name:
Contact Phone #: Address:
Address 2: City:
State: Zip:
DOB: Month   Day   Year

Do you have the legal right to work in the United States? YesNo
Are you fluent in the English language? YesNo
Have you had a DUI in the past 10 years? YesNo
How many moving violations and at fault accidents have you had in the past 3 years?
What type of vehicle will be used under contract?
What year is the vehicle that will be used under contract?
Is the vehicle that will be used under contract registered in your name? YesNo
Are you Drug Free? YesNo
Can you lift between 25 and 75 lbs? YesNo
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