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Alternatively, you can download our application to print and fill out offline and return to our office.

DOWNLOAD: Midstate Tank Application Form

Application

Before you begin, please look over the form to make sure you have all the available information as many fields are required (*). If you do not see a confirmation when you click submit or receive a confirmation via email your application has not been processed. If you're having trouble please call 217-728-8383 during regular business hours.

Desired Position*
Desired Location*
- Sullivan
- Arthur
Desired Salary
Hourly Rate (or equivalent)
Desired Availability*
Check any that apply
- Full-Time
- Part-Time
- Temporary
Desired Start Date*
Desired End Date*
(For Temporary Availability only)
Are you willing to travel?*
- Yes
- No
Personal Information
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Enter Email Confirm Email
Last 4 of Social Security Number*
Please enter the last four digits of your Social Security Number
Please enter a value between 0000 and 9999.
Date of Birth*
I am at least 18 years of age*
If no, then you will need to provide proof of work eligibility
- Yes
- No
Citizenship*
- I am a legal citizen of the United States
- I am NOT a legal citizen of the United States
Are you prevented from becoming lawfully employed?*
Due to Visa, Immigration Status or Other
- Yes
- No
Education Information
Education Levels Attained
Please check any that apply
- G.E.D.
- High School
- Technical School
- College
G.E.D. Information
G.E.D. Graduation State*
High School Information
High School Years Completed?*
Please enter a value between 1 and 5.
High School Name*
High School Address*
Street Address Address Line 2 City State ZIP Code
Additional High School Activities
Technical School Information
Certificate/Degree Acquired*
Technical School Name*
Technical School Address*
Street Address Address Line 2 City State ZIP Code
Additional Technical School Activities
College Information
College Years Completed?*
Please enter a value between 1 and 12.
List of Degree(s) Acquired
College Name*
College Address*
Street Address Address Line 2 City State ZIP Code
Additional College Activities
Military Information
Military Status*
- I've never served in the U.S. Armed Forces
- Veteran of the U.S. Armed Forces
- Current Member of the National Guard or Reserves
Branch of Service*
- Air Force
- Army
- Coast Guard
- Marines
- Navy
Years of Military Service Completed*
Please enter a value between 1 and 30.
Military Job, Duties, Qualifications and Schools*
Employment Information
Do you have friends or relatives that are currently employed with us?*
- Yes
- No
Name(s) and Relationship of Workers*
Have you ever applied for employment with us before?*
- Yes
- No
Date Applied*
Have you ever been employed with us before?*
- Yes
- No
Start Date Employed*
End Date Employed*
Are you currently employed?*
- Yes
- No
- Laid-Off (and Subject to Recall)
How many previous employers would you like to add to this application?*
- 1
- 2
- 3
- 4
- 5
1st Most Recent or Current Employer
Employer's Name
Employer's Address
Street Address Address Line 2 City State ZIP Code
Employer's Phone
May we contact this employer?*
- Yes
- No
Supervisor's Name
Position and Duties
Salary
Hourly Rate (or Equivalent)
Start Date
End Date
Reason For Leaving
(if applicable, else leave blank)
2nd Most Recent Employer
Employer's Name
Employer's Address
Street Address Address Line 2 City State ZIP Code
Employer's Phone
May we contact this employer?*
- Yes
- No
Supervisor's Name
Position and Duties
Salary
Hourly Rate (or Equivalent)
Start Date
End Date
Reason For Leaving
(if applicable, else leave blank)
3rd Most Recent Employer
Employer's Name
Employer's Address
Street Address Address Line 2 City State ZIP Code
Employer's Phone
May we contact this employer?*
- Yes
- No
Supervisor's Name
Position and Duties
Salary
Hourly Rate (or Equivalent)
Start Date
End Date
Reason For Leaving
(if applicable, else leave blank)
4th Most Recent Employer
Employer's Name
Employer's Address
Street Address Address Line 2 City State ZIP Code
Employer's Phone
May we contact this employer?*
- Yes
- No
Supervisor's Name
Position and Duties
Salary
Hourly Rate (or Equivalent)
Start Date
End Date
Reason For Leaving
(if applicable, else leave blank)
5th Most Recent Employer
Employer's Name
Employer's Address
Street Address Address Line 2 City State ZIP Code
Employer's Phone
May we contact this employer?*
- Yes
- No
Supervisor's Name
Position and Duties
Salary
Hourly Rate (or Equivalent)
Start Date
End Date
5th Reason For Leaving
(if applicable, else leave blank)
List Additional Skills
Include any pertinent activities, apprenticeships, certifications, training or schooling
References
How many personal references would you like to add to this application?*
- 1
- 2
- 3
1st Reference Name and Phone Number
1st Reference Years Known
Please enter a value between 1 and 65.
2nd Reference Name and Phone Number
2nd Reference Years Known
Please enter a value between 1 and 65.
3rd Reference Name and Phone Number
3rd Reference Years Known
Please enter a value between 1 and 65.
Are there specific days or times to best contact you?*
- Yes
- No
Best Days to Contact You
- Sunday
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
- Saturday
From:

: HH

MM
To:

: HH

MM
How did you learn about us?*
- Advertisement
- Employment Agency
- Internet Search
- Employee
- Friend
- Relative
Upload Files
Uploads can include: Cover Letter, Resume, Completed PDF Application, Employment Eligibility Documents, Education Diplomas, Military Documents (DD-214) and any other Certifications (10 files / 64mb total)
Drop files here or

Accepted file types: jpg, jpeg, png, gif, pdf, tif, tiff, doc, docx.
Signature*
Sign using your mouse (or finger on a mobile device)
“I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT, IF EMPLOYED, FALSIFIED STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR DISMISSAL. I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED HEREIN AND THE REFERENCES AND EMPLOYERS LISTED ABOVE TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THT MAY RESULT FROM UTILIZATION OF SUCH INFORMATION. I ALSO UNDERSTAND AND AGREE THAT NO REPRESENTATIVE OF THE COMPANY 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, UNLESS IT IS IN WRITING AND SIGNED BY AN AUTHORIZED COMPANY REPRESENTATIVE.”
Security Check
Please check this box to verify you're not a SPAM bot.
Number
Email
This field is for validation purposes and should be left unchanged.

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