Independent Contractor Questionnaire

First Name

Last Name

Address

City

State

Zip Code

Email

Phone

You must be at least 18 years old, have a valid driver's license, own or have access daily to reliable transportation, and possess proof of insurance in your name. Do you meet these minimum standards?

Yes
No

Please select what type of vehicle do you primarily drive?

Please select which best describes your primary vehicle?

Do you have access to a secondary vehicle?

Yes
No

Please select the type of your secondary vehicle?

Please select which best describes your secondary vehicle?

Do you have any experience delivering newspapers?

Yes
No

Have you ever delivered newspapers for Herald-Dispatch, Charleston Gazette-Mail, or other HD Media newspapers?

Yes
No

What relevant experience or comments would you like to share with our delivery supervisors as we consider your credentials?