LogoCommunity-Based Youth Application 

| Resume a previously saved form
Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

Password must contain the following:
  • 12 Characters
  • 1 Uppercase letter
  • 1 Lowercase letter
  • 1 Number
  • 1 Special character
Community-Based Mentoring Program Overview
Dear Parent/Guardian,

Thank you for your interest in Big Brothers Big Sisters of Central Minnesota (BBBS).  To help determine if the program is a good fit for your child, please learn more below.


What is the purpose?

The purpose of the program is for each enrolled youth to achieve higher aspirations, greater confidence, better relationships, 

educational success, and avoidance of risky behaviors .  National research has shown that being in a positive relationship with a volunteer mentor (we refer to them as "Bigs") has a direct and measurable benefit in a youth's life (we refer to the youth in our program as "Littles").  Littles in our program:

  • Are more confident
  • Are more likely to stay away from drugs and alcohol
  • Do better in school
  • Get along better with family and friends
  • Feel better about themselves

How does it work?
A Big will meet with your child approximately two to four times per month either in person or virtually.  The activities they do together may include going to the park, watching a movie, playing sports or playing board games.  We will match your child with a Big who has similar interests.  A Big Brothers Big Sisters staff member (called a Program Coordinator) will monitor the progress of the match to ensure the match is safe, everyone is happy with the match and that the youth's needs are being met.

Who are our Bigs?
Our Bigs are volunteers in our community.  They range in age from 18 to 70+ years of age.  The safety of all youth is extremely important to us, therefore each Big in our program must complete a thorough screening process conducted by a professional staff.


Who are our Littles?

Youth in our Community-Based Program must meet the following criteria:

  • Be between the ages of 7 and 16 at the time of enrollment
  • Reside in Benton, Morrison, Stearns, Sherburne and Northern Wright County
  • Be capable of benefiting from a relationship with a Big
  • Want a Big and understand the role of a Big
  • Have a parent/guardian willing to be a partner with us by maintaining contact and helping keep us informed of changes within the family/match

We want to make sure that we find the best match for your child.  Just as it takes time for anyone to make new friends, it may take us a while to find the right Big.  Bigs and Littles are matched based on parental preference, similar personalities, geographic location and shared interests.


The next step in the process is to complete this application. We do need you to complete an application for each youth you would like involved in the program.


Thank you,

Big Brothers Big Sisters of Central MN 

Inclusion Statement

At Big Brothers Big Sisters of Central MN, diversity, equity, and inclusion (DEI) is an integral part of our values and mission.  We recognize, affirm, and celebrate the diverse backgrounds, lives, and experiences of our stakeholders, including youth, families, board members, donors, volunteers, and staff.  We ensure the opportunity for voices and perspectives to be heard and honored.  In the community, we foster an environment where people can be their best selves.


We affirm that every person [regardless of ability, age, cultural background, ethnicity, faith, gender, gender identity, gender expression, income, national origin, race or sexual orientation, marital or veteran status] has the opportunity to reach their full potential.  We strive to realize the full potential that is within all of us by ensuring that voices and perspectives are heard and honored.

Hidden Fields
To look up the owner's email for notifications
For notifications
Youth Information
Enter birthdate in the following format: mm/dd/yyyy
Start typing to find your child's school
This is the year the youth will graduate.
Use this Graduation Year Calculator for Assistance.
Press CTRL while choosing to select multiple
Health Information
Guardian Information
Type NA if unemployed
Family Information
Please include apartment number if this applies

Physical Address
Please include apartment number if this applies.
Emergency Contact
Existing Household Members
Please choose this youth's relationship to the following people:


Additional Questions








Interest Inventory

Parents/Guardians: Please complete this with your child.  This will help us to match your child with a Big with similar interests.
Confidentiality Policy


Big Brothers Big Sisters of Central Minnesota respects the confidentiality of client and volunteer records and, with the exception of situations listed below, shares information about clients and volunteers only among the agency professional staff.


All records are considered the property of the agency and not the agency workers or clients or volunteers themselves. Records are not available for review by the clients or volunteers.


1. Information will be released to other individuals or non-BBBS organizations only with the client or volunteer's written consent.


2. For purposes of program evaluation, audit, or accreditation, and with the prior approval of the Board of Directors, certain outside bodies such as Big Brothers Big Sisters of America may have access to client and volunteer records.


3. Members of the Board of Directors or evaluators appointed by the Board have access to client files upon authorization of the Board of Directors.


4. Information shall only be provided to law enforcement officials or the courts pursuant to a valid and enforceable subpoena.


5. Information shall be provided to an agency's legal counsel in the event of litigation or potential litigation involving the agency.


6. State law mandates that suspected child abuse be reported to the appropriate authorities (law enforcement or social services).


7. If an agency worker receives information indicating that a client or volunteer may be dangerous to themselves or to others, necessary steps may be taken to protect the appropriate party. This may include a medical referral or report to the local law enforcement authorities. 


8. At the time a youth or volunteer is considered as a match candidate, information is shared between the prospective match parties. The information about the volunteer may include such items as: age, sex, race, religion, interests, hobbies, marriage, family status, sexual orientation, living situation, etc. Information about the child may include such items as age, sex, sexual identity, race, religion, interests, hobbies, family situation, etc.

Medical Release
Social Media Guidelines

Big Brothers Big Sisters of Central MN recognizes that social media, and other digital technology is an integral communication tool. In general, personal use of social media sites is typically for communications between peers, including friends and family. Not all social networking sites are designed to support mentoring relationships. BBBSCM encourages volunteers to interact with their youth on a one-to-one, in-person basis, but understands that there are certain circumstances where the use of social media is acceptable with specific authorizations and safeguards to ensure a mentee’s safety, confidentiality, and privacy. When necessary to communicate outside of face to face, BBBS encourages matches to communicate on a BBBS provided or approved platform.

 

It is the policy of BBBSCM that all agency volunteers, youth, and Parent/Guardians who engage in the use of digital technology (texting, video chats) and/or social networking, which includes, but not limited to social media, blogs, wikis, Twitter, Facebook, etc., agree:


  1. To remain a positive role model in all postings and/or communications.
  2. To respect our youth, families, staff and volunteers’ privacy and dignity.
  3. To honor privacy and confidentiality by not sharing confidential information about a youth, family, volunteer, employee or BBBS, or use their image without consent, even in a private forum.
  4. To model healthy boundaries when communicating over social media/digital technology. Examples: To use prudent judgement in the time and manner in which you are contacting each other.
  5. To be transparent in interactions
  6. To be aware of surroundings especially when utilizing video technology.
  7. To ensure privacy controls and settings restrict accessibility of youth in the program to only age-appropriate content when using any device while in the care of the volunteer.
  8. To speak respectfully about BBBS and those affiliated with BBBS and refrain from posting information that reflects negatively on BBBS or any match participants.
  9. To report any potentially inappropriate content immediately to BBBS.
  10. To abide by any other policy or procedure that BBBS may put into effect regarding social media, social networking and/or digital technology.
  11. Most social media platforms have requirements that minors be age 13 before using the service. Mentors should not connect with youth under the age of 13 on social media.
  12. To adhere to all local, state and federal laws. 
If you would like to review the full Digital Technology & Social Networking Policy please review page 8 or our Community-Based Parent/Guardian Handbook.

Media Release

Parent/Guardian Agreement

By signing below, I give permission:

 

  • For my child to participate in the Big Brothers Big Sisters Program;
  • For the volunteer matched with my child, who has been screened and approved by Big Brothers Big Sisters, to personally interact with and transport my child to events and match activities;
  • For the school to provide social and academic information about my child to Big Brothers Big Sisters (e.g. report cards, behavior reports);
  • To have my child participate in an intake interview conducted by Big Brothers Big Sisters staff and complete questionnaires throughout their time in the program containing questions about school, home life, the match, and personal interests to evaluate and improve program services;
  • To have my child talk with a Big Brothers Big Sisters staff person about personal safety;
  • For my child to communicate with their Big and the BBBS Program Coordinator in person, over the phone, using the BBBS communication platform/other virtual technology, using mail and/or via email;
  • Big Brothers Big Sisters of Central MN utilizes text messages to communicate with participants in our program.  At any time, you wish not to receive these texts please reply STOP. You will not receive any texts from us after that. 
For BBBS staff to provide contact information for me and my child to the volunteer.

 

I understand that the program is not obligated to match my child with a volunteer and that as part of the enrollment process, I will be asked to provide additional information through an in-person interview. I understand that the information I provide in the enrollment process will be kept confidential, unless disclosure is required by law.  I understand that incidents of child abuse or neglect, past or present, will be reported to proper authorities. (Big Brothers Big Sisters  staff and all Bigs are mandated reporters) I understand that certain relevant information about my child will be discussed with the volunteer who is a prospective match (i.e. demographic information, information relevant to volunteer preferences, and information relevant to child-safety and well-being).

 

I certify that all of the information on this form is true and correct and that all income is reported.  I understand this information is being given for the receipt of federal funds, that the information on this application may be verified, and that deliberate misrepresentation of the information may subject me to prosecution under applicable state and federal laws. I understand this information will not affect my qualification for the program.

 

I, on behalf of myself and my child, completely release and forever discharge Big Brothers Big Sisters and its employees, agents, members, volunteers and all other persons on its behalf, together with any successors in interest, heirs, attorneys, agents, representatives, and all persons acting by, through, under, or in concert with them from all known and unknown charges, complaints, claims, grievances, liabilities, obligations, promises, controversies, damages, actions, causes of action, suits, rights, demands, costs, losses, debts, penalties, fees, wages, attorneys’ fees and costs, and punitive damages of any kind or nature whatsoever, whether known or unknown, which I may have, or may have had, against Big Brothers Big Sisters, arising from any participation in said program and activities, including but not limited to any liability to any right of action that may occur to such child directly, or to me as their guardian.  I intend and understand that this release and discharge is to be interpreted and enforced so as to provide the broadest release and discharge possible as may be permitted by law.  I understand that this information may be shared with the school or with partnership agencies when applicable.

 

If my child is matched with a Big Brother or Big Sister I agree to support my child’s match by reviewing the program and safety information given to me by Big Brothers Big Sisters, communicating with Big Brothers Big Sisters staff as outlined in expectations (which includes communication at least once a month in the first year of the match), and immediately reporting any concerns I might have to Big Brothers Big Sisters staff.