Bigsforkids.org - Be a Big

Volunteer Application

Application to be (a):

Community-Based Applicant
School-Based Applicant
Couples for Kids
Hispanic Mentoring Applicant

First Name:

Last Name:

Date of Birth:

Ethnicity:

Gender:

Male Female

Address:

City:

State:

County:

Zip Code:

Home Phone:

Work Phone:

Cell Phone:

Email:

Social Security Number:

Marital Status:

Occupation:

Employer:

Employer's Address:

Employer's City:

Employer's State:

Employer's Zip Code:

How Long Employed:

Can We Contact At Work:

Yes No

Work Hours:

Do you have a Driver's License?:

Yes No

State of Issue and License #:

Driver's License Expiration Date:

Have you ever applied before to be a Big Brother or Big Sister?

Yes No

If Yes, When and Where?

What, if any, other youth organizations have you worked for or been
involved with as a volunteer?

REFERENCES - Please complete the information below by identifying THREE people who can vouch for your reputation and character. 1) Your current or past employer who has known you for at least one year; 2) A co-worker, friend, or neighbor who has known you for at least two years; and 3) A close family member or second friend who has known you for at least three years.

Employer's Name:
(or school if student)

Supervisor's Name:
(or teacher if a student)

Address:

City:

State:

Zip:

Day Phone:

Fax:

Email:

Co-worker or
Personal Reference:

Relationship:

Address:

City:

State:

Zip:

Day Phone:

Fax:

Email:

Personal Reference:

Relationship:

Address:

City:

State:

Zip:

Day Phone:

Fax:

Email:

By checking the boxes, you acknowledge and agree that:

		you are not obligated, if called upon, to perform the volunteer services herein applied for and that BBBS is not obligated to assign, or actively seek to assign, you a Little Brother/Sister;
		the information provided may be used to conduct a background check, to include driving records, criminal background check, and other records where required by local, state, or federal law for volunteers working with youth;
		the references you listed may be contacted by mail, telephone, or email;
		other BBBS agencies or youth organizations where you worked or volunteered may be contacted as references, and;
		as a part of the enrollment process, you will be asked to provide additional personal information prior to any recommendations for assignment.