THE MIDWESTERN TRADING GROUP Online Application You can also print this page and fax it to us at 319-362-7703. Required fields marked with an Asterisk* *First Name:     Middle Initial: *Last Name: *Address: *City: *State: *Zip Code: *Phone:         Alt Phone: *Email: SSN: Position you are applying for?:   When are you available to start?:   EDUCATION INFORMATION High School/College School Name: Special Training and Related Courses Completed REFERENCES Please list two professional, and one personal reference. List NAME, PHONE or Company Name 1) 2) 3) EMPLOYMENT HISTORY Beginning with the most recent, please list past employment 1)Company Name: Address: Phone: Your Position: Supervisors Name: Start Date:      To:   Reason For Leaving: 2)Company Name: Address: Phone: Your Position: Supervisors Name: Start Date:      To:   Reason For Leaving:   I certify that the facts contained in this application form are true and complete to the best of my knowledge. This form will be submitted to Midwestern Trading's HR Department. You can reach the HR department at 319-366-5854 or email HR@midwesterntrading.com

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Midwestern Trading, Inc.
500 Stickle Dr. NE
Cedar Rapids, IA 52401
PH: 319-366-5854
FAX: 319-362-8212