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Services
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Careers

Contact

Application For Employment

Step 1 of 5

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Contact Information
Name*
First Middle Last
Address*
Street Address Address Line 2 City State/Province ZIP/Postal Code Country
Phone*
Email*
What source led you to make an application with us?
Type of work you wish to be considered for:*
Have you previously worked for Mid-America Contractors, LLC?*
- Yes
- No
If you have previously worked for Mid-America Contractors, LLC, when/where?
Hours and days of availability:
- Days
- Nights
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
- Saturday
- Sunday

Qualifications
ISTC:
- Basic Plus
- Confined Space
- Fire Guard
- Fire Watch
- Site Specific (please specify)
- Other
Basic Plus ISTC Expiration Date:
Confined Space ISTC Expiration Date:
Fire Guard ISTC Expiration Date:
Fire Watch ISTC Expiration Date:
Please specify Site Specific ISTC and provide Expiration Date:
Please specify Other ISTC and provide Expiration Date:
Please list any relevant NCCER Certifications:
Please upload a copy of any relevant certificates:
Drop files here or

Max. file size: 100 MB, Max. files: 4.
Do you have a TWIC Card?*
- Yes
- No
Please provide TWIC Card expiration date:
Do you have a Hazwoper 40Hr?
- Yes
- No
Please provide Hazwoper 40Hr expiration date:
If you are an experienced operator of any machines or equipment, please list and indicate if you have a license to operate:
Please list any other relevant certifications or training:
Do you have any other skills you wish to mention?

Employment History
Please list your complete employment history. List present or most recent employer first.
Employer #1
Name of Employer*
Start & End Dates of Employment (Mo/Yr- Mo/Yr)*
Type of Work Performed*
Present or Last Salary
Reason For Leaving (if applicable)*
Employer #1 City & State*
Name of Supervisor
Do you have another employer to include?
- Yes
- No
Employer #2
Name of Employer*
Start & End Dates of Employment (Mo/Yr- Mo/Yr)*
Type of Work Performed*
Present or Last Salary
Reason For Leaving (if applicable)*
Employer #2 City & State*
Name of Supervisor
Do you have a third employer to include?
- Yes
- No
Employer #3
Name of Employer*
Start & End Dates of Employment (Mo/Yr- Mo/Yr)*
Type of Work Performed*
Present or Last Salary
Reason For Leaving (if applicable)*
Employer #3 City & State*
Name of Supervisor
Do you have a fourth employer to include?
- Yes
- No
Employer #4
Name of Employer*
Start & End Dates of Employment (Mo/Yr- Mo/Yr)*
Type of Work Performed*
Present or Last Salary
Reason For Leaving (if applicable)*
Employer #4 City & State*
Name of Supervisor
Do you have a fifth employer to include?
- Yes
- No
Employer #5
Name of Employer*
Start & End Dates of Employment (Mo/Yr- Mo/Yr)*
Type of Work Performed*
Present or Last Salary
Reason For Leaving (if applicable)*
Employer #5 City & State*
Name of Supervisor
Do you have a sixth employer to include?
- Yes
- No
Employer #6
Name of Employer*
Start & End Dates of Employment (Mo/Yr- Mo/Yr)*
Type of Work Performed*
Present or Last Salary
Reason For Leaving (if applicable)*
Employer #6 City & State*
Name of Supervisor

Education
High school name/location:
Grades Completed:
- 7th
- 8th
- 9th
- 10th
- 11th
- 12th
Earned Diploma?
- Yes
- No
List any major courses:
I attended:
- College
- Business/Trade School
College name/location:
Degree Obtained
- Some College
- Associates
- Bachelors
- Masters
- Other
List any major courses:
School name/location:
Months Attended:
List any major courses:
If you served in the United States Armed Forces, briefly describe the skills you acquired:

Personal Information
Are you legally authorized to work in the U.S.?*
- Yes
- No
Note: You will be required to furnish documents to verify your eligibility for employment in accordance with the Immigration Reform and Control Act and your employment is contingent upon furnishing such documents.
Are you at least 18 years of age?*
- Yes
- No
Have you EVER been convicted of a crime or are there any pending charges against you?*
- Yes
- No
Note: A conviction does not automatically bar you from employment.
If you answered yes to the question above, please provide details:
Are you presently employed?*
- Yes
- No
If you answered yes to the question above, may we contact your present employer?*
- Yes
- No
If hired, when would you be available to begin work?
What are your salary requirements?
Reference #1
Name
First Last
Occupation
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Reference #2
Name
First Last
Occupation
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone

Our Clients

Motiva

Shell

Chevron

Total

KinderMorgan

ExxonMobil

Cargill

BASF

oxyvinyls

ohmstede black white

monument_chemical black and white

keyera black and white

contanda black and white

magellan black and white

P&G

Our Clients

Shell

P&G

Motiva

KinderMorgan

ExxonMobil

Chevron

Cargill

BASF

Total

magellan black and white

monument_chemical black and white

ohmstede black white

keyera black and white

contanda black and white

oxyvinyls

Associations & Memberships

WBENC

Osha

sba8alogo

HMSDC

GTMBC

WBENC

Osha

sba8alogo

HMSDC

GTMBC

Business Office

3900 East Parkway
Groves, TX 77619
Phone:409-962-3600

Hiring & Training Center

101 Procter Street
Port Arthur, TX 77640
Phone: 409-963-3300

Operations Office

39271 IH-10
Winnie, TX 77665
Phone: 409-237-2327

Deer Park Location

203 Ivy Ave, Suite 400
Deer Park, TX 77536
Phone: 281-884-8133

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