Adult Volunteer Application

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Thank you for your interest in becoming a Big Brother or Big Sister. If you have any questions as you complete this form, do not hesitate to contact us at rwilhelm@bbbsmantycounty.org.
All applications will be given equal consideration regardless of race, age, sex, disability, marital status, sexual orientation, religion or national origin.

Email *

Full Name: (First, Middle, Last) *

Gender *

Date of Birth: *

YYYY

Social Security Number & Driver's License or Other Identification

Big Brothers Big Sisters will need your social security number and copy of your driver's license in order to complete your application and run a background check. You can give that to BBBS via phone call, text, or in person.

Phone Number(s): *

Home Address, Number, Street, City and Zipcode) *

Race/Ethnicity (Check all that Apply) *

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

White

Other:

Required

Occupation & Place of Employment (or School if student) *

Highest Level of Education: *

Do you have current or past military experience? *

Yes

Do you have a current and valid driver's license? (We will need a copy of this.) *

Yes

Other:

Do you have access to a vehicle and valid insurance that meets or exceeds state required minimums? (We will need a copy of this if participating in Community-Based Program) *

Yes

Not Applicable - because participating in School-Based Program where I will not be transporting my Little

Other:

Have you previously applied to be or served as a Big Brother or Big Sister here or anywhere else? *

Yes

Have you ever been involved with Big Brothers Big Sisters in a capacity other than a Big? *

Yes

Have you ever been denied acceptance or released from service as a volunteer or employee for another Big Brothers Big Sisters program or youth-serving organization? *

Yes

REFERENCE INFORMATION: (References will be contacted, typically via email and/or text - please let these people know in advance)

Please list information for at least three references below including:
1. Your spouse or domestic partner (i.e. if you live with a significant other/girlfriend/boyfriend) OR a family member, if you do not have a spouse, partner, etc.
2. Current or former employer/supervisor or co-worker you have known for at least one year, (or someone from school if you are a student), AND
3. A friend, neighbor, or other personal reference you have known for at least two yeras.

Spouse/Partner's Name, or Family Member's Name (Include Name, Phone Number(s), and Email Address) *

Current or former employer/supervisor or co-worker you have known for at least one year, (or someone from school if you are a student). *Include Name, Phone Number(s), and Email Address *

An adult friend/neighbor, etc. or other personal reference you have known for at least two years. (Include Name, Phone Number(s), and Email Address) *

Youth Serving Organization Reference: (References will be contacted)

In addition to the references above, Big Brothers Big Sisters requires references from all youth serving organizations at which you have worked or volunteered in the past.

Please Include: Organization Name. Direct Supervisor Name. Phone Number. Email Address.

I consent to and understand that:

1. The references and youth serving-organization I listed may be contacted by mail, telephone, email, or in-person;
2. The information I provided may be used to conduct a background check, to include a search of public domain records, driving records check, juvenile and adult criminal history check, military records, and other records where required by local, state, or federal law for volunteers working with youth;
3. I am in no way obligated to perform any volunteer services;
4. The BBBS agency is not obligated to match me with a youth and may deny my application or close my match at any time, and to protect all participants’ confidentiality, BBBS is not required to disclose reasons for doing so;
5. Other BBBS agencies and youth organizations where I have worked or volunteered may be contacted as references;
6. As part of the enrollment processes, I will be required to provide additional personal information, including completion of an in-person interview;
7. I understand that the information I provide in the enrollment process will be kept confidential, unless disclosure is required by law and with exceptions noted below.
8. I understand that incidents of child abuse or neglect, past or present, must be reported to proper authorities;
9. I understand that certain relevant information about me will be discussed with the parent/guardian of a child who is a prospective match (this might include demographic information, information relevant to parent/child preferences, and any information relevant to a child’s safety or well-being);
10. It is my responsibility to update the agency if any of the information I provide on this application, in my interview, or any other information provided during the enrollment process changes (i.e. address, phone number, auto-insurance, new criminal charges, etc.).
11. I agree to timely communication and follow-up with all agency staff.
12. I understand that this is an application for a volunteer opportunity and is not a promise or commitment by Big Brothers Big Sisters.

I certify that all information I have provided or will provide to Big Brothers Big Sisters, including this application, is true, correct and complete to the best of my knowledge. I certify that I have and will answer all questions to the best of my ability and that I have not and will not withhold any information that would affect my application for a volunteer position. I understand that information contained on my application will be verified by Big Brothers Big Sisters. I understand that misrepresentations or omissions may be cause for my immediate rejection as an applicant or my termination as a volunteer.
At any time while involved with the Big Brothers Big Sisters program, I agree to immediately inform my Big Brothers Big Sisters contact person of any and all infractions, violations, charges and convictions related to any civil, domestic, or criminal occurrences. I understand that BBBS staff needs to be fully informed to provide the best guidance or support possible.

By writing my name below and submitting this form, I understand that I am signing an official document used as my application. *

Today's Date: *

YYYY

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