If you are in High School and interested in earning Service Hours with the Jefferson Parish Animal Shelter, 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.