JC Shovels Volunteer Form
Instructions: Fill out this form to be listed as a volunteer for the City of Jersey City’s program: JC SHOVELS. Volunteers are to provide their services to help disabled and senior homeowners that cannot shovel snow.

Volunteers are to abide by the following guidelines:
1. Participation is voluntary and unpaid; no volunteer should solicit money from resident receiving the service.
2. Volunteer must be 16 year and older
3. Volunteers should wear proper winter clothing when shoveling.
4. Shoveling should be done no more than 24 hours after snow fall.
5. Volunteers are only to shovel the sidewalk, pathway to the entrance of the home; and place salt.
6. Salt should only be used on the sidewalk of residents receiving the service, no other property.
7. Shovels and salt need to be returned to their storage location.
Email address *
Date of Application
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How many seniors are you willing to serve?
Your answer
Name *
Your answer
Date of Birth *
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Address *
Your answer
City, State, Zip Code *
Your answer
Phone Number *
Your answer
Emergency Contact Information
Please include: Their name, address, contact information and relationship to applicant.
Your answer
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