Join Jay Shop · Pontiac, Michigan

Application for employment.

Take the next step toward meaningful work. Complete your application below and send it directly to Jay Shop.

It is our policy to comply with all applicable state and federal laws prohibiting discrimination in employment based on race, age, color, sex, religion, national origin, disability or other protected classifications.

Please carefully read and answer all questions. Required fields are marked with an asterisk (*). Complete each applicable section; use the explanation fields when you do not have references or work history.

Your application is sent to Jay Shop and stored privately using Netlify Forms. Do not enter your Social Security number, date of birth, medical information, or other sensitive identifiers in any field. Jay Shop will collect any needed identity documents privately later.

01 Personal information

First name

Middle initial

Last name

Street address

City

State

ZIP code

Email address

Phone number

Emergency contact name

Emergency contact phone

02 Availability & eligibility

Jay Shop works Monday–Thursday, 7:00 AM–5:30 PM. Fridays are sometimes available and on rare occasions required.

Have you previously worked at Jay Shop?

Are you a U.S. citizen?

Are you available during these work hours?

Date you can start

Have you ever been convicted of a felony?

If yes, what was the charge?

03 Education

High school

College

College name (if applicable)

04 Special skills

Enter “None” if you have no skills or experience to list.

List any special skills or experience that would help you in the position you are applying for.

05 References

Please list three professional references not related to you. If you do not have three professional references, list personal, unrelated references. If you have fewer than three, explain below.

Reference 1

Name

Relationship

Phone number

City

State

Reference 2

Name

Relationship

Phone number

City

State

Reference 3

Name

Relationship

Phone number

City

State

Explanation if you have fewer than three references

06 Work history

Start with your present or most recent employer and work back. If this is your first job, check the box below.

Employer 1

Company name

Job title

Start date

Last day

Wage per hour ($)

Reason for leaving

Employer 2

Company name

Job title

Start date

Last day

Wage per hour ($)

Reason for leaving

Employer 3

Company name

Job title

Start date

Last day

Wage per hour ($)

Reason for leaving

This would be my first job.

07 Certification & signature

Review your answers before submitting. By typing your name and submitting, you confirm this application is yours.

I certify that the facts set forth in this Application for Employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements, omissions, or misrepresentations may result in my dismissal. I authorize Jay Shop, Inc. to make an investigation of any of the facts set forth in this application and release Jay Shop, Inc. from any liability. Jay Shop, Inc. may contact any references listed on this application. I also acknowledge and understand that Jay Shop, Inc. is an “at will” employer. Therefore, any employee (regular, temporary, or other type of category employee) may resign at any time, just as Jay Shop, Inc. may terminate the employment relationship with any employee at any time, with or without cause, with or without notice to the other party.

I have read and agree to the certification above. *

Type your full name as your signature

Date

Your answers are sent only when you submit. Need help? Call (248) 335-9156 or email info@jayshop.org.