Be a Big - Volunteer Application

References

Please provide at least three references. A reference from a Spouse/Spousal Equivalent or Significant Other is required. Substitute a family member if no Spouse/Spousal Equivalent or Significant Other. Please only list references that you have known for at least one year.

Spousal/Familial Reference

Spousal/Familial Reference ID

First Name

Last Name

Email

Phone

Relationship to you

Years Known

Professional Reference

First Name

Last Name

Email

Phone

Relationship to you

Years Known

Personal Reference

First Name

Last Name

Email

Phone

Relationship to you

Years Known

Have you held a volunteer or paid position where you worked with children in the last five years? (for example counselor at a camp, babysitting, nannying, coaching, etc.)

Volunteer Experience

Organization Name

Location

Start Date

End Date

Direct Supervisor First Name

Direct Supervisor Last Name

Phone

Email

Years Known

Reason for Leaving

I understand that:

The references and youth organizations that I have worked for, or been involved with as a volunteer, whose information I have provided may be contacted by telephone or email.
I am in no way obligated to perform any volunteer services.
The information I provide may be used to conduct a background check, to include a driving records check, criminal background check, and other records where required by local, state, or federal law for volunteers working with youth. If matched, the information I provided may also be used to conduct an annual criminal background and driving records check. Continued involvement will be based on the information discovered.
Big Brothers Big Sisters of Southwest Michigan has the right to accept or deny program participants and is not obligated to match me with a youth. Big Brothers Big Sisters is not required to provide me with a reason if I am not accepted or matched with a youth.
Background checks will be updated every 3 years while I am still matched with a youth.
As part of the enrollment process, I agree to provide additional personal information to assist Big Brothers Big Sisters of Southwest Michigan in making a recommendation for matching.

I accept these terms and conditions:

American Indian or Alaska Native	Asian - Chinese
Asian - Filipino	Asian - Indian
Asian - Japanese	Asian - Korean
Asian - Other	Asian - Vietnamese
Black or African American	Hispanic - Cuban
Hispanic - Mexican,Mexican American,Chicano	Hispanic - Other Latinx or Spanish origin
Hispanic - Puerto Rican	Middle Eastern or North African
Pacific Islander - Chamorro	Pacific Islander - Native Hawaiian
Pacific Islander - Other	Pacific Islander - Samoan
White or Caucasian	Other
Prefer not to say