Volunteer Application Form

Please complete this application form if you are interested in becoming a Jefferson Protection & Animal Welfare Services volunteer. Once you complete the form, click the Continue button at the bottom.

Name and address

Please enter your first and last name and street address.

First name:

Last name:

Title:

Street 1:

Street 2:

Street 3:

City:

State:

Zip:

Contact Information

Please provide the best phone number to reach you.

Home phone:

OK to call me here

Cell phone:

OK to call me here

Email

Email address:

Emergency Contact Information

Please enter first and last name, and at least one phone number for your emergency contact person.

First name:

Last name:

Home phone:

Work phone:

Cell phone:

Relationship:

Over the age of 16?

If you are under the age of 16, please indicate your age here.

Date of birth:

* (year optional)

Age:

Do you need Service Hours for School?

If so, indicate number of hours needed.

I would like to serve up to:

School Currently Attending (If applicable)

School:

Special Skills?

If you have any special skills, please tell us about them! Social Media savy, photography, animal training experience, etc.

T Shirt Size

Please indicate your T shirt size.

T-Shirt size:

Reference

Please give us the name, phone and email of a personal reference that we may contact.

First name:

Last name:

Home phone:

Cell phone:

Email address:

Relationship:

Availability

Sun

Mon

Tue

Wed

Thu

Fri

Sat

From:

To:

My availability is:

From:

to:

Shelter Location

Do you prefer to volunteer at our East Bank shelter at 1 Humane Way, Harahan, or our West Bank shelter 2701 Lapalco Blvd., Harvey?