Carpool Logistics

Car Shipment Order Form

Effective Date

Effective Date *

Origin Contact

Origin Contact Name *

First

Last

Contact Phone Number *

Contact Email Address *

Origin Address

Address *

Address Line 1

City

State

Zip Code

Origin Details

Origin Details (Check all that apply)

Residential Address
Gated
Accessible pick area for Semi-Truck

Origin Pickup Date & Time

Earliest Pick Up Date & Time *

Date

Time

Latest Pick Up Date & Time (copy) *

Date

Time

Destination Contact

Destination Contact *

First

Last

Destination Phone Number *

Destination Email Address *

Destination Address

Destination Address *

Address Line 1

City

State

Zip Code

Destination Details

Destination Details (Check all that apply)

Residential Address
Gated
Accessible pick area for Semi-Truck

Destination Pickup Date & Time

Earliest Drop Off Date & Time *

Date

Time

Latest Drop Off Date & Time (copy) *

Date

Time

Vehicle Information

17-Digit VIN Number

Year *

Make *

Model *

Other Shipment Details

Vehicle Details (Check all that apply) *

The vehicle starts, runs, and drives
I want my vehicle transported in an enclosed trailer (additional fee applies)
I want my vehicle shipment expedited (additional fee applies)

Carpool platform makes car shipping easy by enabling multiple clients to share space on one truck, lowering cost and emissions. We pride ourselves on providing transparency and communication throughout the entire process to provide a great customer experience.

By signing this Order Form, you expressly acknowledge and agree to be bound by the Carpool Terms & Conditions. To better familiarize yourself with the car shipping process please review our FAQs. The payment link will be sent 2-3 days prior to the scheduled pickup date and needs to be processed prior to the vehicle being loaded.

Signature

Signature *

Todays Date *