| Additional Information |
| The following information is needed to conduct the necessary background and reference checks required to complete your application. |
| How did you hear about us?:* | |
| Applying for::* | |
| Social Security Number: | |
| Do You Have a Driver's License?:* |
Yes
No
|
| Driver's License State of Issue and License #: | |
| Driver's License Expiration Date: | (mm/dd/yyyy) |
| Have you ever applied before to be a Big Brother or Big Sister?:* |
Yes
No
|
| If yes, when and where have you applied before?: | |
| What other youth organizations have you worked for or been involved with as a volunteer, if any?: | |
| Reference #1 Name (Employment Supervisor or Teacher):* | |
| Reference #1 Company Name (or School, if student):* | |
| Reference #1 Daytime Phone:* | |
| Reference #1 Email Address: | |
| Reference #2 Name (Personal Reference):* | |
| Reference #2 Relationship to You: | |
| Reference #2 Daytime Phone:* | |
| Reference #2 Email Address: | |
| Reference #3 Name (Personal Reference):* | |
| Reference #3 Relationship to You: | |
| Reference #3 Daytime Phone:* | |
| Reference #3 Email Address: | |
| Check the box to acknowledge and agree that:* |
you are not obligated, if called upon, to perform the volunteer services herein applied for, and BBBS is not obligated to assign, or actively seek to assign, you a Little Brother or Little Sister.
|
| Check the box to acknowledge and agree that:* |
the information provided in this application may be used to conduct a background check, including driving records, criminal background, and other records where required by local, state, or federal law for volunteers working with youth.
|
| Check the box to acknowledge and agree that:* |
the references you listed may be contacted by mail, telephone, or email.
|
| Check the box to acknowledge and agree that:* |
other BBBS agencies or youth organizations where you worked or volunteered, if any, may be contacted as references.
|
| Check the box to acknowledge and agree that:* |
as a part of the application process, you will be asked to provide additional personal information prior to any recommendations for assignment.
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