If you are in High School and interested in earning Service Hours with the Jefferson Protection & Animal Welfare Services (JPAWS) please complete this application form. Once you complete the form, click the Continue button at the bottom.

Name, address, and contact information.

First name:

Last name:

Nickname:

Street 1:

Street 2:

Street 3:

City:

State:

Zip:

Home phone:

OK to call me here

Cell phone:

OK to call me here

Email address:

Demographic Information

You may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.

Date of birth:

(year optional)

Age:

Education:

T-Shirt size:

School:

1

2 Availability

Please indicate the days and times you are usually available to volunteer.

Sun

Mon

Tue

Wed

Thu

Fri

Sat

From:

To:

I would like to serve up to:

hours:

Emergency Contact Information

Please provide at least one Emergency Contact here.

1

2

First name:

Last name:

Home phone:

Work phone:

Cell phone:

Email address:

Relationship:

Reference

Please provide the name, email and phone number of a personal reference.

This can be a teacher, academic advisor, coach, clergy member, employer, neighbor, etc.

Shelter location

Which shelter do you prefer to volunteer at? Our East Bank shelter is at 1 Humane Way, Harahan. Our West Bank shelter is at 2701 Lapalco Blvd., Harvey.