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How were you referred to Landscape Forms?
Have you applied with us recently? *
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Are you 18 years of age or older? *
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Yes
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Are you authorized to work for any U.S. employer without restriction both today and in the future? *
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Yes
No
Have you ever been fired, dismissed, asked to resign, resigned by mutual agreement, or otherwise been terminated from any job? *
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Yes
No
If yes, please explain:
Have you ever been convicted of any crime other than a routine traffic offense? (Includes a "no contest" or "guilty" plea) *
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Yes
No
If yes, please explain:
Are you currently under indictment or charged with a felony? *
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Yes
No
Are you able to perform the essential functions of the job(s) for which you are applying with or without a reasonable accommodation: *
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Yes
No
What is your salary requirement? *
Are you presently Employed?
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Yes
No
If yes, why do you want to change your job?
TERMS *
PLEASE READ CAREFULLY AND SIGN BELOW IF YOU AGREE TO THESE TERMS OF EMPLOYMENT.
Certification of Truthfulness: I represent that all my statements in support of my Application for Employment are true and complete. I understand and agree that if Landscape Forms Inc., at any time, should determine that any requested information was withheld by me or any of my statements are false or misleading, I may be discharged.
Employment at Will: If hired by Landscape Forms Inc., I agree to comply with all rules, regulations, policies, and communications directed to employees, including any changes made from time to time. I understand that I will be free to resign my employment at any time with or without cause, and with or without prior notice or warning to Landscape Forms Inc.; I agree that Landscape Forms Inc. also may terminate my employment at any time, with or without cause and with or without prior review, notice, or warning.
Limitation on Claims: I agree that any lawsuit against Landscape Forms Inc. and/or its agents arising out of my employment or termination of employment, including but not limited to claims arising under State or Federal civil rights statutes must be brought within the following time limits or be forever barred: (a) for lawsuits requiring a Notice of Right to Sue from the EEOC, within 30 days after the EEOC issues that Notice; or (b) for all other lawsuits, within (i) 90 days of the event(s) giving rise to the claim, or (ii) the time limit specified by the statute, whichever is shorter. I waive any statute of limitations that exceeds this time limit.
In addition, team members expressly waive any constitutional or statutory rights to a trial by jury in any action, litigation, proceeding, charge, or claim that they might bring or assert against Landscape Forms and/or its agents arising out of employment or termination of employment. Team members make this waiver knowingly, voluntarily, and intentionally. They fully understand that it prohibits them from asserting a right-to-jury trial in any and all actions, litigation, proceedings, charges, or claims that may arise out of employment with Landscape Forms.
Jurisdiction and Choice of Law: All disputes arising from my application for employment, and my employment, shall in all respects be governed by the laws of the State of Michigan, and any hearing concerning policies within the Guidebook shall be filed, heard, and decided in the Circuit Court for the County of Kalamazoo, Michigan. The parties agree that they will be subject to the personal jurisdiction and venue of that court regardless of where the team member or Landscape Forms may be located at the time that any dispute or action may occur.
Authorization to Work: I certify that I can produce applicable documentation that I am authorized to work as required by the Immigration Reform and Control Act of 1986.
Need For Accommodation: If I, due to a physical or mental disability, require an accommodation to perform the job for which I may be selected, I understand that I must give Landscape Forms Inc. written notice of that need within 182 days after I know or reasonably should have known that an accommodation is needed. Failure to do so may bar me from alleging that Landscape Forms Inc. has not accommodated me as required by Michigan law.
Drug Testing: I agree to provide Landscape Forms Inc. with appropriate specimens to test for the presence of drugs or other controlled substances. I authorize the release of any and all information relating to this test, including but not limited to medical reports, laboratory reports, test or evaluation. I understand that decisions concerning my employment will be made as a result of these tests.
Disclosures: I agree that the contents of any offices, work spaces, desks, computer and computer generated data, any Landscape Forms Inc. property I may be using, as well as my person, and any of my own property I bring onto Landscape Forms Inc. premises, may be inspected by Landscape Forms Inc. at any time, and I waive and promise not to make any claims against Landscape Forms Inc. (or its employees or agents) relating to such inspection. I agree that, except as directed otherwise in writing by Landscape Forms Inc., I will not disclose to anyone, use for my own purposes, or access for any purpose other than LFI’s business interests, any of confidential or proprietary information, either during or after my employment. I understand and agree that client names and information, financial data, computer information and processes are confidential and proprietary information and I will not make written or other copies or notes regarding these matters except as necessary to perform my job. I agree that if my employment ends, I will deliver to Landscape Forms Inc. all material of any kind that I have relating to its business, including any such copies or notes. I agree that if any of the above commitments by me is ever found to be legally unenforceable as written, the particular agreement concerned shall be limited to allow its enforcement as far as legally possible.
Consideration for Employment: I agree to the above terms of employment if I am employed by Landscape Forms Inc.. Should I be employed, I understand and agree that these provisions of my employment can be revised only by a signed contract authorized by a written resolution of Landscape Forms Inc., and that no person in Landscape Forms Inc. has any authority to offer employment other than on an at-will basis as described above. I understand and agree that, except as provided above, all compensation, benefits, programs, rules, and policies of Landscape Forms Inc. are subject to exception or change at any time as decided by Landscape Forms Inc. in its sole discretion.
I understand that I may submit this application at a later time if I choose to do so. I acknowledge by clicking the "YES" box below that I have been given adequate time to read, complete, and review my application and this certification, and I have knowingly and voluntarily checked the box below.
I have read and understand the items listed in this Application for Employment, including this page, and acknowledge that by checking "YES" here.
Please select YES
Authorization and Waiver *
This authorization and waiver is part of my electronic application for employment with Landscape Forms, Inc.
I authorize all employers and educational institutions where I am or have been employed or enrolled, and all law enforcement agencies, to disclose to Landscape Forms Inc. any and all information in their possession about my employment history (including disciplinary and other matters), personal background, and/or credit background. I hereby waive written or other notices from all such parties of their release of any such information to Landscape Forms Inc. I further authorize all educational institutions I have attended to disclose to Landscape Forms Inc. any and all information in their possession regarding my attendance and performance at such institution, including but not limited to: disclosure of any diploma or degree of certification awarded; disclosure of academic information and transcripts; and disclosure of any disciplinary record. I hereby waive written or other notice from such institution of its release of any such information to Landscape Forms Inc.
I understand that under Michigan’s Bullard-Plawecki Employee-Right-To-Know Act I am entitled to notice of the release of information from my personnel record, and I hereby specifically waive any such notice from any prior employer.
I release all my prior employers and educational institutions, and all law enforcement agencies, from any liability or claim relating to the release of information, records or opinions to Landscape Forms Inc., or to any employment decisions made by Landscape Forms Inc. as a result thereof.
For purposes of this Authorization and Waiver, a photocopy of my signature shall have the same force and effect as my original signature.
I have read and understand the items listed in this Waiver, including this page, and acknowledge that by checking "YES" here.
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Yes
No
Voluntary Self-Identification For government reporting purposes, we ask candidates to respond to the below self-identification survey.
Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiring
process or thereafter. Any information that you do provide will be recorded and maintained in a
confidential file.
As set forth in Landscape Forms’s Equal Employment Opportunity policy,
we do not discriminate on the basis of any protected group status under any applicable law.
Gender
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Are you Hispanic/Latino?
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Please identify your race
Please select American Indian or Alaskan Native
Asian
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Hispanic or Latino
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Two or More Races
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Race & Ethnicity Definitions
If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection.
As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measure
the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categories
is as follows:
A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.
A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.
An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.
An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.
Veteran Status
Please select I am not a protected veteran
I identify as one or more of the classifications of a protected veteran
I don't wish to answer
Voluntary Self-Identification of Disability
OMB Control Number 1250-0005
Expires 04/30/2026
Why are you being asked to complete this form?
We are a federal contractor or subcontractor. The law requires us to provide equal employment opportunity to qualified people with disabilities. We have a goal of having at least 7% of our workers as people with disabilities. The law says we must measure our progress towards this goal. To do this, we must ask applicants and employees if they have a disability or have ever had one. People can become disabled, so we need to ask this question at least every five years.
Completing this form is voluntary, and we hope that you will choose to do so. Your answer is confidential. No one who makes hiring decisions will see it. Your decision to complete the form and your answer will not harm you in any way. If you want to learn more about the law or this form, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp .
How do you know if you have a disability?
A disability is a condition that substantially limits one or more of your “major life activities.” If you have or have ever had such a condition, you are a person with a disability. Disabilities include, but are not limited to:
Alcohol or other substance use disorder (not currently using drugs illegally)
Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, HIV/AIDS
Blind or low vision
Cancer (past or present)
Cardiovascular or heart disease
Celiac disease
Cerebral palsy
Deaf or serious difficulty hearing
Diabetes
Disfigurement, for example, disfigurement caused by burns, wounds, accidents, or congenital disorders
Epilepsy or other seizure disorder
Gastrointestinal disorders, for example, Crohn's Disease, irritable bowel syndrome
Intellectual or developmental disability
Mental health conditions, for example, depression, bipolar disorder, anxiety disorder, schizophrenia, PTSD
Missing limbs or partially missing limbs
Mobility impairment, benefiting from the use of a wheelchair, scooter, walker, leg brace(s) and/or other supports
Nervous system condition, for example, migraine headaches, Parkinson’s disease, multiple sclerosis (MS)
Neurodivergence, for example, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, dyslexia, dyspraxia, other learning disabilities
Partial or complete paralysis (any cause)
Pulmonary or respiratory conditions, for example, tuberculosis, asthma, emphysema
Short stature (dwarfism)
Traumatic brain injury
Disability Status
Please select Yes, I have a disability, or have had one in the past
No, I do not have a disability and have not had one in the past
I do not want to answer
PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.
