New Job Test Form

Applicant's Statement
- This application for the companies of Gudelsky Group, which includes Chantilly Crushed Stone Inc., Loudoun Quarries, 495 Trucking Inc., Gudelsky Materials and any of their affiliates (hereinafter referred to as the “Company” or “Gudelsky Group.” I understand that Gudelsky Group is committed to providing equal opportunity in all employment practices, including but not limited to selection, hiring, promotion, transfer, and compensation to all qualified applicants and employees without regard to age, race, color, creed, national origin, sex, religion, disability, ancestry, marital status, or any other category protected by law.
- I authorize former and present employers, work and personal references listed in the application, and any other individuals I may name, to give Gudelsky Group or its designee any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release such parties from all liability.
- I understand that Gudelsky Group reserves the right, to the extent permitted by law, to require a medical examination including, but not limited to any drug screening test, urinalysis, blood test, breathalizer, or other procedure, of any applicant or an employee either prior to employment or any time during employment and I hereby give my consent to any such test or examination to Gudelsky Group. I understand that any hiring decision is contingent upon my successful completion of all of the company’s lawful pre-employment checks. I agree to execute any consent forms necessary for the company to conduct its lawful pre-employment tests.
- I understand that this employment application and any other Company documents are not promises of employment. Should I be employed, I understand my employment will be on a trial period for ninety days from the date of my hiring, I further understand that, if I am employed, I can terminate my employment with or without cause and with or without notice, at any time, and that the Company has a similar right. I understand that no manager or representative of Gudelsky Group, has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, except that a corporate officer may do so in writing.
- The information given by me in this application is true and complete in all aspects, and I agree that if the information is found to be false, misleading or unsatisfactory in any respect (in the exclusive judgement of the Company) that I will be disqualified from consideration for employment or subject to immediate dismissal if discovered after I am hired.
- I understand that should an employment offer be extended to me and accepted, that I willfully adhere to the policies, rules, and regulations of employment with the company.
Maryland Applicants Only
Under Maryland law, an employer may not require or demand as a condition of employment, prospective employment, or continued employment, that an individual submit to or take a lie detector or similar test. An employer who violates this law is guilty of a misdemeanor and subject to a fine of not exceeding $100.
Do not check until you read and understand the above statement*
- I have read and understand all of these statements.
Applicant Information Form
Upload Resume
Accepted file types: pdf.
Upload a pdf file of your resume.
Which company or companies, are you applying to?*
- 495 Trucking, Inc.
- Chantilly Crushed Stone, Inc.
- Gudelsky Materials
- Loudoun Quarries
Position Desired:*
Position*
- Full Time
- Part Time
- Temporary
Enter the date you may be able to start work with us.*
Contact Information
Name*
First Last
Present Address*
Street Address City State / Province / Region ZIP / Postal Code Country
How many years have you lived there?*
Previous Address
Street Address City State / Province / Region ZIP / Postal Code Country
How many years have you lived there?
Home Phone*
Email*
How should we contact you?*
Are you legally authorized for employment in the United States?*
(Proof of identity and employment eligibility will be required within 3 days of hire.)
- Yes
- No
Are you 18 years of age or older?*
- Yes
- No
Have you ever worked for this company before?*
- Yes
- No
If yes, give date:*
Do you have any friends or relatives working here?*
- Yes
- No
If yes, name(s):*
How were you referred to us?*
Name of referral service:
Education
Please indicate if you received diploma/degree and describe course of study or major.
High School Name*
Years attended*
Did you earn a diploma?*
- Yes
- No
College/University Name
Years attended
Did you obtain a degree?
- Yes
- No
Name of Degree/Major
Graduate/Professional School Name
Years attended
Did you obtain a degree?
- Yes
- No
Name of Degree/Major
Trade/Correspondence School Name
Years attended
Did you obtain a degree?
- Yes
- No
Name of Degree/Major/Certificate
Additional Skills and Training
Pleases feel free to provide any additional information you feel would assist us on evaluating your application for employment, including technical training/education, professional certificates, registrations and memberships, scholastic awards and honors. If you choose, you may include any military service, language abilities, volunteer work or similar activity. You need not provide any information which might indicate race, color, religion, national origin, age, gender, disability, veteran status, or any category protected by federal, state, or local laws.
Record of Previous Employment
Please list the names of your present or previous employers in chronological order with present or last employer listed first. If self-employed, five firm name and supply business references.
Present or Last Employer
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Position
Supervisor
Reason for Leaving
Duties
Dates Employed
Enter From and To date
Salary
Enter Start and Final amount
Previous Employer
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Position
Supervisor
Reason for Leaving
Duties
Dates Employed
Enter From and To date
Salary
Enter Start and Final amount
Previous Employer
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Position
Supervisor
Reason for Leaving
Duties
Dates Employed
Enter From and To date
Salary
Enter Start and Final amount
Have you ever been terminated or asked to resign from any job?*
- Yes
- No
If yes, please explain the circumstances:*
May we contact your current employer?*
- Yes
- No
If no, please explain:*
Do you have any commitments to any other employer which may affect your employment?*
- Yes
- No
If yes, explain:*
Have you been cited for a traffic violation of any kind within the last FIVE years?*
*NOTE: Answering "YES" to this question does not constitute to automatic bar to employment
- Yes
- No
If yes, please give date and details:*

Applicant's Statement

Maryland Applicants Only

Applicant Information Form

Contact Information

Education

Record of Previous Employment