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Volunteer Application

Non-Discrimination Policy

Big Brothers Big Sisters of Middle Tennessee welcomes volunteers of all races, ages, sexes, abilities, marital statuses, sexual orientations, religions, national origins, genders, gender identities, and gender expressions.

Basic Information

















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File can be a screenshot, PDF, or picture



File can be a screenshot, PDF, or picture

Please list all the different cities you have lived in within the last seven years and ALL states in which you have lived outside of Tennessee at any time.



Contact Information

























Type First and Last Name



To ensure safety, our process includes a basic screening of other adults living in a volunteer's home. Please list the full name, other names used (maiden, alias, etc.), and birth date of ALL adults 18 year or older living in your home:

Employer Information













Additional Information








Previous Experience



References and Background Check

Please provide at least three references. Your references will be contacted within one week of the interview, so please notify your references that someone from our agency will be contacting them.

  • BBBSMT is required to obtain a reference from any youth serving program an applicant has volunteered or worked for in the last 5 years i.e. Girl Scouts, daycare, YMCA, or other programs serving children. Please be prepared to discuss these experiences during your in-person interview and provide contact information (name, phone number and email address) for someone who supervised you during that time. 
  • BBBSMT also requires references from significant others/spouses and current roommates of applicants. Please be prepared to provide contact information (name, phone number and email address) for these individuals. Substitute a family member if no significant other or spouse/spousal equivalent is available. 
  • You will also be asked to provide 1-3 additional references from co-workers, friends and family members. Please be prepared to provide contact information (name, phone number and email address) for these individuals as well. 
Spouse/Significant Other/Partner/Girlfriend/Boyfriend







Professional Reference






Personal Reference (Friends, Family Members, Co-workers, Adult Roommates)








Youth Serving Experience











VOLUNTEER AGREEMENT WITH BIG BROTHERS BIG SISTERS OF MIDDLE TENNESSEE:

I understand and agree that:
  1. Other BBBS agencies or youth organizations where I have worked or volunteered may be contacted as references;
  2. As part of the enrollment process, I will be asked to provide additional personal information in an interview prior to consideration as a volunteer;
  3. I agree to have an ongoing obligation to notify Big Brothers Big Sisters immediately of any changes in my driving or criminal records, and my auto insurance coverage;
  4. The references I listed may be contacted by mail, telephone, or email;
  5. I am in no way obligated to perform any volunteer services;
  6. The information I provided may be used to conduct a background check, to include driving records check, criminal background check, and other records when required by local, state, or federal law for volunteers working with youth. The background check may be conducted periodically as determined by the agency;
  7. The BBBS agency is not obligated to approve or 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.

I grant to Big Brothers Big Sisters of Middle Tennessee the right and permission to copyright and/or publish video and/or photographic portraits or pictures in which I may be included in whole or in part of composite or reproductions made through any media or photography for art, advertising, trade or any other similar lawful purpose, including television and product packaging.       

I waive my right to inspect and/or approve the finished product or the advertising copy that may be used in connection therewith. I hereby release and hold harmless Big Brothers Big Sisters of Middle Tennessee, its agents, successors and all persons acting under its permission or authority from any liability whatsoever by virtue of any publication, dissemination, or processing.


Type First and Last Name

GRIEVANCE SYSTEM 

  

I understand that should I ever have a concern, complaint, or grievance of any kind, the steps available to me are:

  1. Speak to my assigned BBBSMT contact to discuss specific concerns, complaints, and/or grievances. If after discussion with my BBBSMT contact I feel that my concerns have not been addressed or remedied, then;

  2. Speak with the Vice President of Programs regarding my concerns. If this conversation does not remedy or address my concerns, then:

  3. Speak with the Chief Impact Officer.  

  

AUTHORIZATION FOR BACKGROUND CHECK

NOTICE

The agency requires a national criminal background and motor vehicle record check prior to approval of any volunteer.  Written authorization will be obtained from the volunteer prior to the submission to the search agent, Verified Volunteers. 

VOLUNTEER CONSENT

I understand that signing this form authorizes Big Brothers Big Sisters of Middle Tennessee to request a criminal background and motor vehicle check from their search agent, Sterling, and use the results to assess my approval as a Big Brother or Big Sister in the program. This authorization allows submission of criminal background and motor vehicle checks for the entire period I am involved in the BBBSMT program. I understand and agree there may be multiple checks depending on the length of time I am involved in the program. 

Type First and Last Name





CONFIDENTIALITY POLICY

The BBBS of Middle Tennessee respects the confidentiality of all clients’ (defined as caregiver/guardian/parent, child, and volunteer) records and, with the exception of situations listed below, shares information about clients only among the agency professional staff.  In order to provide service, which is in the best interest of the children served by the program, information from outside sources, including confidential references must be assessed along with information gained from the clients.  It is the agency’s responsibility to protect the confidentiality of reference responses and counseling reports by not disclosing their content to a client applicant.  Therefore, the agency may decide not to disclose the reason for rejection to the client.   

 

All records are considered the property of the agency and not the agency workers or clients themselves.  Records are not available for review by the clients.  Clients must sign this summary statement indicating an understanding of the agency’s confidentiality policy and agree to program participation under the guidelines before being accepted into the program.   

 

Information will be released to other individuals or non-BBBS organizations only with the client's written consent.  Identifying information regarding clients may be used in agency publications or promotional materials unless the client requests otherwise.  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 records.  Members of the Board of Directors or evaluators appointed by the Board have access to client files upon authorization of the Board of Directors.  Information shall only be provided to law enforcement officials or the courts pursuant to a valid and enforceable subpoena.  Information shall be provided to an agency's legal counsel in the event of litigation or potential litigation involving the agency. 

 

State law mandates that suspected child abuse be reported to the appropriate authorities (Tennessee Department of Children’s Services or local law enforcement agency).  If an agency worker receives information indicating that a client may be dangerous to himself or herself 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. 

 

At the time a child or volunteer is considered as a match candidate, information is shared by the agency with 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, gender identification, living situation, etc.  Information about the child/parent may include such items as: age, sex, race, religion, interests, hobbies, family situation, sexual orientation, gender identification, living situation etc. 

 

I understand that some information, including opinions of the social worker, may be shared with parents of a potential Little Brother or a Little Sister or a potential volunteer.  I hereby give my authorization for such limited release and use of information that may otherwise be deemed confidential pursuant to the policies contained in the complete confidentiality policy statement and I release and waive any liability against the organization, all Big Brothers Big Sisters personnel and the Board of Directors of said organization.   


Type first and last name

Firearms and Weapons Guidelines and Attestation

I agree to keep any weapon and ammunition inaccessible to the child assigned to me by BBBSMT while he/she is in my care.

As a volunteer, I understand and agree to abide by the Weapons policy of BBBSMT. 

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