Driver Application

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    Personal Information

    List Your Addresses of Residency for the Past 3 Years

    Previous Addresses


    Employment History

    The Federal Motor Carrier Safety Regulations (49 CFR 391.21) require that all applicants wishing to drive a commercial vehicle list all employment for the last three (3) years. List complete mailing address, street number, city, state, and zip code.

    In addition, if you have driven a commercial vehicle previously, you must provide employment history for an additional seven (7) years (for a total of ten (10) years). Any gaps in employment in excess of one (1) month must be explained.

    (NOTE: List employers in reverse order starting with the most recent. Attach additional documentation (step 6) if necessary to provide the required employment history.)

    Add Previous Employers
    Employer 1

    Employer 2

    Employer 3

    Employer 4

    Employer 5

    Employer 6


    Driving Experience

    Accident Record
    Accident 1

    Accident 2

    Accident 3

    Traffic Convictions

    Traffic convitions and forfeitures for the past 3 years (other than parking violations)

    Traffic Conviction 1

    Traffic Conviction 2

    Traffic Conviction 3

    Traffic Conviction 3

    Qualification 1

    Qualification 2

    Qualification 3

    Other Experience

    Class of Equipment


    Education History

    High School










    I authorize you to make investigations (including contacting current and prior employers) into my personal, employment, financial, medical history, and other related matters as may be necessary in arriving at an employment decision. I hereby release employers, schools, health care providers, and other persons from all liability in responding to inquiries and releasing information in connection with my application.

    In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I also understand that I am required to abide by all rules and regulations of the Company.

    I understand that the information I provide regarding my current and/or prior employers may be used, and those employer(s) will be contacted for the purpose of investigating my safety performance history as required by 49 CFR 391.23. I understand that I have the right to:

    • Review information provided by current/previous employers;

    • Have errors in the information corrected by previous employers, and for those previous employers to resend the corrected information to the prospective employer; and

    • Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.

    This certifies that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge. Note: A motor carrier may require an applicant to provide more information than that required by the Federal Motor Carrier Safety Regulations.

    I authorize Dave Gutelius Excavating, Inc. to contact, obtain and verify the accuracy of the information contained in this application from all previous employers, educational institutions and references. I also hereby release from liability Dave Gutelius Excavating, Inc. and its representatives for seeking, gathering and using such information to make employment decisions and all other persons or organizations for providing such information.

    I certify that the information provided on this application is true and correct and I understand that any misrepresentation or omission of information will be justification for termination of employment with Dave Gutelius Excavating, Inc., if I am employed.

    I understand that this application for employment or being granted an interview is not a contract of employment. It is also understood that any employment relationship with Dave Gutelius Excavating, Inc. is At-Will and I have the right to terminate my employment with proper notice at any time for any reason and that Dave Gutelius Excavating, Inc. has the same right, so long as there are no violations of applicable state or federal employment laws.

    I understand that all employment offers are conditional upon passing pre-employment testing. All field employees will be required to complete and pass a drug and alcohol screen due to the nature of the job duties. All office employees will be required to complete and pass a drug and alcohol screen. All employees will also need to have a satisfactory criminal background history and have an acceptable MVR to drive company vehicles/equipment. In addition, new/prospective employees with a CDL must give consent within the FMCSA’s Drug and Alcohol Clearinghouse for Dave Gutelius Excavating, Inc. to conduct the required pre-employment full query of the CDL driver. This full query will provide access to full details of all violations and violation-related information including return-to-duty information. Failure to give consent will rescind any employment offer. Failure to submit to pre-employment testing or the inability to pass pre-employment testing will rescind any employment offer. Any employment offers could also be rescinded if your criminal history will make you unable to work on jobsites that require submission of criminal history reports.

    I understand that if I am employed, I will be required to provide satisfactory proof of identity and legal work authorization within three days of being hired. Failure to submit within the required time shall result in immediate termination of my employment.

    I represent and warrant that I have read and fully understand the foregoing, and that I seek employment under these conditions.