Our Mission

The Mission of Jay Nolan Community Services, Inc. (JNCS) is to enable individuals with Autism Spectrum Disorder and other Developmental Disabilities to live fulfilling lives as members of the community by providing support services customized to their individual needs

Current Personal Information

Historical Information

Position & Availability

Employment Record

List below all present and past employment for the last ten years starting with your most recent employer. Please include self-employment, military service with any branch of the U.S. Armed Forces, part-time or summer-time work and job-related volunteer experience. If more space is needed, please email additional sheets.

Present or Past Employer

Past Employer 2

Past Employer 3

Past Employer 4

Periods of Unemployment

Please identify and explain all periods of unemployment in excess of one month during the past 10 years:


Basic Education

College or University

Trade / Vocational / Business / Other

Current Courses


Please list any other Languages that you Speak, Read or Write

If offered a position, the Immigration Reform & Control Act of 1986 requires you to furnish proof of your employment authorization and your identity within 3 business days of your date of hire.


List reference below (3 business, 3 personal), other than a relative or employer who has knowledge of your work performance.


I hereby certify that I have personally completed this application, and that the information contained herein is correct to the best of my knowledge. I understand that any misrepresentation, falsification of material, or omission of information on this application, in my interview(s) or pm-employment evaluation will result in my failure to receive an offer or if I have been hired, may result in my dismissal from employment.

I authorize the Company and its agents to request any information and records concerning me, including but not limited to consumer credit, criminal history, driving, employment, military, civil and educational data and reports: from any present or previous employers (unless expressly stated), consumer reporting agencies, licensing and law enforcement agencies, courts and other agencies. Further, if I am employed, I agree to submit to pm-employment and employment-related examinations of the above-described information at any time, upon probable cause, at the request of Jay Nolan Community Services.

I authorize and request any present or former employer, school, financial institution, credit agency or any governmental agency or persons having personal knowledge about me to furnish Jay Nolan Community Services or its agents with any and all information in their possession regarding me, which is reasonably related to my employment, or continued employment with Jay Nolan Community Services. I authorize that a photocopy may be accepted with the same authority as the original.

I understand that any offer of employment will be conditioned on the Company's receipt of satisfactory responses to reference requests, the provision of satisfactory proof of my identity and legal right to work in the United States, the satisfactory completion of a background check conducted through the Dept. of Justice, a T.S. test, and other bona-fide employment testing.

I understand that misrepresentation or omission of facts called for is cause for dismissal. Further, I understand and agree that if employed, the employment relationship is for an unspecified term and is considered employment-at-will and that no one other than the Executive Director of the Company has the right or the authority to enter into any written or verbal agreement for different terms of employment. I also understand and agree that the employment relationship can be terminated at will, either by me or the Company, with or without cause or advance notice.

I understand that the Company retains the right to establish compensation, benefits, and working conditions for all of its employees. Accordingly, I understand and agree that the Company retains sole discretion to modify my compensation, benefits, position, duties, and other terms and conditions of employment, including the right to impose discipline of whatever type and for whatever reasons Jay Nolan Community Services at its sole discretion, determines to be appropriate. No employee or representative of the Company, other than the Executive Director, has the authority to alter at-will nature of my employment relationship or make any agreement contrary to the foregoing.