2018 NTDC Registration Information The Nebraska Trucking Association’s Safety Management Council is hosting the 2018 NTDC on June 8-9 in

Grand Island, Nebraska. This annual event showcases the state’s finest drivers and the outstanding companies

these drivers represent.

In order to register, drivers your company must be a member of the Nebraska Trucking Association. You

may enter a maximum of five drivers in each class of competition. Drivers must compete in the class indicated

on their official entry form.

To be eligible, your employee drivers and permanent-lease owner-operators:

• must have an accident-free record for the 12 months preceding June 8, 2018

• must have been employed by your company during the same time

• must have driven for you at least 11 of the past 12 months

• must be a permanent resident of Nebraska or must report to a terminal domiciled in Nebraska

• must have the appropriate class of CDL, and any required endorsements, for the class in which they are

competing

Make sure to complete and return all registration forms for each driver, including:

• the 2018 driver entry and release form and announcer information

• a current MVR (dated after 3/1/2018)

• a copy of CDL

• a $35 fee (this fee DOES NOT include meal tickets)

All paperwork and fees must be received by the Nebraska Trucking Association at 1701 K St, Lincoln,

NE, 68508 no later than Tuesday, May 1, 2018 or the driver(s) will not be eligible to compete.

Once NTA receives all necessary forms and fees you will receive two championships shoulder patches and a

2018 Facts for Drivers book for each driver. Questions for the written exam will be taken from this book

and current events from Good to Know.

The headquarters hotel Ramada Midtown in Grand Island, NE can accommodate most of the participants and

volunteers. However, there’s still a good chance the hotel will sell out long before the event. Make your

reservations as soon as possible. The Ramada Midtown's number is (308) 384-1330.

At the championships, the drivers will participate in:

• a written test to demonstrate their knowledge of regulations and safety

• a personal interview to show their ability to represent your company

• a pre-trip inspection to display their equipment safety awareness

• a driving course to demonstrate their driving skills on key challenges faced daily

Incentives First, second and third place winners in each class receive trophies. Additional awards are given to

the drivers who achieve the highest scores on the written test, pre-trip and driving skills portions of the

competition. We also recognize a Grand Champion, a Rookie of the Year, Professional Excellence award

recipient, Jerry Wessel All-Around Driver, Kurt Everett Vehicle Condition award recipient, R.J.”Bucky”

Buchholz Top Driver award recipient, and a team title earned by the company with the highest average score.

A company must have at least three drivers to be considered for the team award.

The champions in each class may advance to American Trucking Associations’ Championships,

Aug. 15-18 in Columbus, OH

Please Note A driver may not practice on company time or be paid for practice time. Violation will disqualify

the driver from the championships. You may, at your option, elect to pay the driver for an actual working day

spent in competition and/or reimburse expenses for the driver and his or her spouse at the championships. You

are urged to adhere to the practice of not paying drivers for normal off-duty hours. If the Saturday of the

championships is a driver’s regular day off, he or she should not be paid for Saturday. A driver may not

compete in any vehicle that he or she has practiced with or driven prior to competition. Violation will disqualify

the driver from the championships.

Championship Classes

• Straight truck driver needs Class A, B or C License

• Three-, four-, five-axle, five-axle sleeper berth and five-axle flatbed driver needs Class A License

• Five-axle tank driver needs Class A License with N or X endorsements

• Twin trailers driver needs Class A License with T endorsement

• Step van driver can be a CDL or non-CDL driver

• Concrete Mixer driver needs Class B License

• Truck and Pup driver needs Class A License

Authorization Form We need one copy of this completed form from each participating company

Company _________________________________________________________________________________

Mailing Address ____________________________________________________________________________

Phone Number _____________________________

Entry authorized by __________________________________ Email _________________________________

Total Number of Drivers registering ___________________________________________________

Driver’s Name Class Qualifies

as

Rookie*?

Qualifies for

Jerry Wessel

award*?

Fee per

driver

($35)

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

Total Fees

*Rookie: Driver competing for the first time in ANY truck driving championships

* Jerry Wessel award: Driver has competed or volunteered at the Nebraska Truck Driving Championships

for at least five years.

Admission to the Championships event is free, but if you wish to eat at scheduled meals, meal tickets need to be purchased ahead of time and are required for meals. Tickets will not mailed, but available for pick up at the Championships registration desk when you pick up your name badge. You will also need to order meal tickets for your drivers, as they are not included in registration. Please complete this form and return it with your payment by Tuesday, May 25, 2018. All the meal prices will go up $5.00 after May 25, 2018.

Company:Name:

Enter ALL drivers and attendees names as you want them printed on name badges, then check the meal(s) they’ll be attending. If eating at scheduled meals, every person must have a ticket for all meals. Duplicate this form if you need additional space. Prices listed are per person.

Name

Total meal fees

Meal Ticket Order Form

Send this form with your check made payable to Nebraska Trucking Association to:

Nebraska Trucking Association • 1701 K St Lincoln, NE 68508

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Please indicate if anyone has special dietary needs:

Note: Saturday lunch has changed. Companies may grill out again at Fonner Park

2018 Truck Driving Championships & Step Van Driving Championships Entry and Release Form

(Be sure to complete Driver Information Sheet on reverse side) Contestant’s Name: Preferred Nickname:

Competition State: Hosting State Assn.:

Employer:

Class of Competition (check one)

Straight Truck (Single 2-axle vehicle)

5-Axle Tractor-Semitrailer(3-axle tractor & 2-axle 53’ semitrailer)

3-Axle Tractor-Semitrailer(2-axle tractor & 1-axle 28’ semitrailer)

5-Axle Sleeper Berth Tractor-Semitrailer(3-axle sleeper tractor & 2-axle 53’ semitrailer)

4-Axle Tractor-Semitrailer(2-axle tractor & 2-axle 53’ semitrailer)

Tank Truck (3-axle tractor & 2-axle tank semitrailer)

CERTIFICATION BY EMPLOYER. I hereby certify that I am aware of the provisions of Chapter V, Truck Driving Championships Eligibility Rules, of the ATA Truck Driving Championships Rules and Procedures, State and National and applicable appendixes includ-ing the Step Van Driving Championships rule summary; that the contestant named herein is eligible to compete under these rules; that the contestant’s employer is a member of an ATA-affiliated State Trucking Association, and that all information furnished about them is true to the best of my knowledge and belief.

Employer Mgr.’sSignature (NOT driver’s):

Mgr. Title:

AGREEMENTS AND RELEASE In consideration of my being permitted to participate in the ATA’s National and/or its affiliates’ Truck Driving Championships (TDC) orStep Van Driving Championships (SVDC) and be eligible for awards offered to participants, I hereby stipulate and agree to the following:

1. I acknowledge that I am not in the employ of ATA or a State Trucking Association.2. Both as to myself and my heirs and personal representatives, I release ATA, its directors, employees, agents and/or any of its

affiliates and the State Association noted above, its directors, employees, agents and/or any of its affiliates from any and all liabilityand any right of action that may arise from any damage or injury which I may receive while attending or participating in said Stateor National TDC or National SVDC.

3. I grant the State Association noted above and ATA and its designated agencies exclusive right to make use of information aboutmyself and of photographs supplied with this entry form, along with photographs subsequently taken under ATA’s direction, inpublicity and advertising activities. I further agree to make myself available for publicity enterprises arranged by ATA, withnewspaper and magazine writers and radio and television personnel.

4. I grant State Association noted above and ATA the right to exam my CDL and MVR for the purposes of determining my eligibility tocompete at both the State and National TDC or SVDC.

5. I will be bound by all orders, rules and regulations governing ATA’s National and/or its affiliates’ TDC or SVDC while partic ipating insaid competitions.

CERTIFICATION BY CONTESTANT. I certify that during the 12 months prior to the 2018 TDC:

1. I have been continuously employed as a truck or step van driver by my present employer [exception: 11 of 12 months if previousemployer went out of business and all other eligibility requirements are met]; and

2. I have driven and performed the regular duties of a truck driver or step van driver for at least 11 of the 12 months, and that myregular duties of a truck driver or step van driver constituted not less than 60% of my work hours and at least 1200 hours annually.

3. I have not been involved in a fleet motor vehicle or motor carrier vehicle accident in the course of such employment.4. I have the proper class Commercial Driver’s License (if a SVDC applicant, not required), plus required endorsement(s) for the class

of competition indicated above.5. That I hold a CDL from or have been occupationally domiciled in the state of ______________________. Occupational domiciled

means the terminal, garage or other operating base from which the driver normally and usually works and/or is supervised.6. That the class of competition I am entering in 2018 is not a class in which I won at the state or regional TDC and/or competed at

the National TDC in 2016 and 2017 or 2015 and 2016; or if I am entering the step van class, I did not win the state or regional TDCand/or compete at the National SVDC in the step van class in 2016 and 2017. I understand that after winning two consecutiveyears at the State TDC and/or competing two consecutive years at the Nationals in that same class of competition, I am not eligibleto compete in that same class for one year if a step van competitor and two years if a competitor in any other class.

7. I further certify that I have not received any form of pay, bonus, prize or other consideration for time spent in practice as set forth inthe ATA Truck Driving Championships Rules and Procedures, State and National.

8. I agree that if I compete and win the State TDC, that I will compete at the National TDC or SVDC (as applicable), unless disqualified oram detained due to a medical emergency, in which case I will notify the applicable State Trucking Association immediately.

9. I acknowledge that any misstatement made with respect to my eligibility for the TDC or SVDC competition may result in theforfeiture of my right to compete or in my disqualification from said competition.

Driver’s Signature: Attach a photocopy of your MVR showing: 1) Your name and/or signature; and 2) Class of CDL (or License if SVDC applicant) Also attach a copy of your CDL. Form TR-1 American Trucking Associations (Rev. 12/17)

Concrete Mixer Truck and Pup

Flatbed (3-axle tractor & 2 axle flatbed semitrailer)

Twin Trailers (2-axle tractor & set of 28’ semitrailers)

Step Van (Step or Package Van)

2017 ATA Truck Driving Championships & Step Van Driving Championships Driver Information Form Contestant’s Name: Home Address:

(first) (middle) (last) (number-street) (city) (state) (zip)

Class of Competition: Home Phone: ( ) Cell Phone: ( )

Competition State: E-mail:

Employer: Married: Yes No Spouse’s Name:

Employer Main Office Address:

Important: (number-street) (city) (state) (zip)

Company President:

Children’s

name(s)/age(s):

Will significant other attend NTDC? Yes No National TDC? Yes No

List unusual experiences, aid to motorists or at accident scene, acts of heroism: (first) (middle) (last)

Safety Director: (full name) (E-mail) Awards received:

Safety Dir. Address: (number-street) (city) (state) (zip) Hobbies:

Terminal Manager: Strangest cargo ever hauled: (full name) (E-mail) Do you volunteer? Where/how:

Termin. Mgr Phone #: ( ) T-shirt size? Jacket Size?

Contestant’s Home Terminal: _______________________________________________________________________________________

How many times have you participated in NTDC? ______ How many times have you participated in a National TDC or SVDC? ______

(number-street) (city) (state) (zip) Below and above Info is used at Nationals to determine ND Professional Excellence Award eligibility.

Length of Service with Present Employer:

Length of Service in Trucking Industry:

Previous State/National TDC or SVDC in which you competed or volunteered: Year State Competed Class Competed Rank Volunteer Role

Number of Years with No-Accident Record:

Lifetime Safe Driving Miles:

Number of Accidents: Preventable: Non-Preventable:

Date of Last Accident:

Usual Run: Local Peddle Line-haul

(Please attached separate history sheet if additional space is needed for above listing)

Yes Have you ever been a member of America’s Road Team? Yes Years: No State: No

Is your company a member of the Nebraska Trucking Association?

Have you been on the state Road Team? Yes Years: No Are you interested in serving on America’s Road Team? Yes No

For State and National publicity purposes include: Have you been on a company Road Team? Yes Years: No

Recent 2” X 3” (or larger) head and shoulder photograph (may be e-mailed as instructed by State Championships Committee or hosting State Trucking Association), and The name of your hometown newspaper: and the nearest large city to your hometown:

Information sheet must be complete to be eligible for National competition! Form TR-2 - American Trucking Associations (Rev. 12/17)

_______________________________ __________________________

2018 NTDC/NSVDC – Competitor/Volunteer History

Name: ____________________________________ State: ____________________________________

Company: _________________________________ Class: ____________________________________

Previous State/National TDC or SVDC in which you competed or volunteered:

NOTE: Continue from TR – 2

YEAR STATE COMPETED

CLASS

COMPETED

RANK

VOLUNTEER ROLE

This information will be used by the announcer as you are taking part in your driving skills test. Please fill out completely and return with your entry form.

Driver’s name Years driving

Company Accumulated miles

Personal information (family hobbies, awards)

How did you get your start in the trucking industry?

What has contributed most to your overall success as a professional truck driver?

What is the strangest or most unusual load you’ve ever hauled?

What do you like most about the championships?

Is this your first year competing? Yes No Number of years you’ve participated in the championships

ANNOUNCER INFORMATION

The name of your hometown newspaper______________________ and the nearest large city to your hometown_________________

Sponsorship Form

Funding is extremely important for producing a high-quality event like the Nebraska Truck

Driving Championships, and we’re deeply grateful for the generosity of our donors. We hope

you’ll be among them this year.

Sponsors of the 2018 Nebraska Truck Driving Championships will have their names printed in

the official championships program, on event signage and in the post-championships issue of

Nebraska Trucker magazine. In addition, sponsors will be recognized via public

announcements during the driving competition on Saturday, June 9.

If you would like to make a donation to this annual celebration of Nebraska’s best professional

drivers, please complete the form below.

I’m proud to be a 2018 Nebraska Truck Driving Championships sponsor!

Company name ________________________________ Contact name __________________

Contact email __________________________ Contact phone _________________________

Please indicate your level of participation:

Gold $100 Platinum $250 Diamond $500 Special Sponsorship*$____________

*Cost for a special sponsorship varies depending on opportunities available

Raffle prize item donated: ______________________________________________________

Payment method

Check payable to Nebraska Truck Driving Championships enclosed OR

Credit card number ________________________ Cardholder name _____________________

Expiration date ___________ CV2 _______ Billing Address __________________________

Please return this completed form with your payment to Nebraska Truck Driving Championships c/o Nebraska Trucking Association

1701 K St

Lincoln, NE 68508

(If charging, you may fax or email this form to: 402-476-8570 or soconnor@nebtrucking.com)

Thank you for your support!

VOLUNTEER

REGISTRATION

Friday, June 8 and Saturday, June 9

Grand Island, NE

Volunteer’s Name_______________________________________________________

Company______________________________________________________________

Cellphone_____________________________________________________________

Email_____________________________________ T-shirt size__________________

I am available to volunteer (check all that apply) Friday

Saturday

Both Days

Please fill out the Meal Ticket Order Form to purchase meal tickets

Please email or fax this completed form to Heidi Loop at heidi@choicetransportllc.com or

fax 402-210-2714 If you have questions about volunteering