Volunteer Application & Consent for Calcasieu, Cameron, Jeff Davis Parishes.

Inclusion Statement

Justice, Equity, Diversity, Inclusion (JEDI) are an integral part of our values and mission. We recognize, affirm, and celebrate the diverse backgrounds, lives, and experiences of all of our stakeholders, including youth, families, donors, volunteers, and staff.

Basic Information








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Contact Information

























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
NOTE for BBBS staff (delete before making the form live): You will need to update the drop down above with the corresponding options for your chapter. Once you've added the locations available to your chapter, go into the Update Contact step in the submit connector and update the Agency Location mappings, using record IDs of the Agency Locations IDs as the send-as values 









Previous Experience



References and Background Check

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.
Partner/Spousal/Familial Reference







Professional Reference






Personal Reference







Volunteer Experience










I understand that:
  1. 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.
  2.  I am in no way obligated to perform any volunteer services.
  3. I will be asked to provide my social security number.
  4. I am required to be FBI fingerprinted.
  5. 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.
  6.  Big Brothers Big Sisters 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.
  7. As part of the enrollment process, I agree to provide additional personal information to assist Big Brothers Big Sisters in making a recommendation for matching.

Authorization to Disclose Criminal History Records Information 

As a new or prospective volunteer of Big Brothers Big Sisters of Southwest Louisiana, I understand that the Parish Sheriffs Office where I reside. and the Louisiana State Police will conduct a thorough investigation of  any record of past criminal activities. I understand and authorize the investigation to be conducted annually and reported directly to Big Brothers Big Sisters of Southwest Louisiana.

 

In addition, during the application process and at any time during the period of volunteering with Big Brothers Big Sisters of Southwest Louisiana, by my signature below, I hereby authorize such an investigation and further authorize the Parish Sheriffs Office where I reside. and the Louisiana State Police and Choice Point Services, Inc./First Advantage to release all criminal record information maintained in their files, which may confirm or deny any eligibility for volunteerism with Big Brothers Big Sisters of Southwest Louisiana.


The above reports may be compiled with information from court record repositories, past or present employers and educational institutions, governmental occupational licensing or registration entities, business or personal references, and any other source required to verify information that I have voluntarily supplied. 


Motor Vehicle Report Authorization

 

I also hereby authorize Choice Point Services Inc./First Advantage, on behalf of Big Brothers Big Sister s of Southwest Louisiana to procure a Motor Vehicle Report annually. This report may be compiled with information from courts record repositories, past or present employers and educational institution s, governmental occupational license or registration entities, business or personal references, and any other source required to verify information that I have voluntarily supplied.



Confidentiality Policy 

BBBS of Southwest Louisiana respects the confidentiality of client and volunteer records and, with the exception of the 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.      Big Brothers Big Sisters of America and its affiliates will have access to an individual’s information without written consent.

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

3.      Identifying information regarding clients and volunteers may be used in agency publications or promotional materials unless the clients or volunteer request otherwise.

4.      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.

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

6.      Information shall only be provided to the agency’s legal counsel in the event of litigation or potential litigation involving the agency.

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

8.      State law mandates that suspected child abuse be reported to the State of Louisiana Department of Social Services Office of Community Services Children Youth and Family Services at 800-814-1584.

9.      If an agency worker receives information indicating that a client or volunteer 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 local law enforcement authorities.

10.   At the time a child or volunteer is considered as a match candidate, information is shared between the prospective match parties.  The information shared about the volunteer may include but not be limited to such items as:  age, sex, race religion, interests, hobbies, marriage, family status, sexual orientation, living situations, etc.  Information about the child may include but not be limited to such items as age, sex, race, religion, interests, hobbies, family situation, etc. 





Social Media

Give the parent/guardian and BBBS of SWLA your website address and, when possible, link your page to the BBBS of SWLA page on that site so that we can follow along with your postings. We are active on Facebook and Twitter.

 

Never post any pictures of your Little online unless you have the written consent of the child’s parent/guardian. Check with your BBBS Case Manager as that consent form should be filed with the agency.

 

Never post the last name of your Little, his parent/guardian or BBBS of Southwest Louisiana staff.

 

Never post any contact information for your Little.

 

Never post any identifying information or contact information for your Little (i.e. child’s address, school the child attends, telephone numbers, parent’s workplace).

 

Never post anything that can be perceived as judgmental or offensive to your Little or his/her parent/guardian.

 

Volunteers must not tag Littles in any photos posted to social media or make any reference to the Little’s profile.  Littles must not tag themselves in photos posted to social media by their volunteer Big. 

 

Be aware of other postings on your page that are not BBBS of SWLA related or are inappropriate for minors. Know that as a BBBS volunteer you are a role model at all times. Please ensure that all contents are appropriate and kid-friendly, in case your Little or his/her family were to read your social networking page.

 

Child Safety Guidelines and Ground Rules for Volunteers                                                                      

You will see your Little Brother/Sister consistently, at least twice a month for a calendar year.

 

Children will be prepared (dressed and on time) when the volunteer arrives.  Parents should ensure this.

 

You will not include other people in the first six weeks and the majority of your activities together.

 

Maintain a primary relationship with your Little and do not become overly involved with the rest of his/her family.

 

Volunteers must never come between a parent and their child; volunteers need to respect a parent’s role and authority.

 

You will inform the parent of match activity plans and obtain their approval.  Communicate with the parent before and after an activity.  Describe what you plan to do and what you actually did.  Let parents know about any changes in plans.  (DO NOT rely on the Little to tell the Parent/Guardian about plans.)

 

You will not engage in activities that pose a risk for injury, such as: speeding, not using seat belts, and disregarding generally adhered to safety guidelines.

 

You will keep confidential any personal information that you learn about your Little Brother/Sister and their family members.

 

If a child or a volunteer is unable to keep an outing appointment, the other party should be contacted as soon as plans change.

 

Volunteer/Child home-visits ARE NOT ALLOWED as per our National Standards and Youth Safety Policies.  You will not bring your Little Brother/Sister to your home.

 

You will not buy, sell, or use drugs while participating in this program.

 

You will not consume any alcoholic beverages before and/or during visits with your Little Brother/Sister.

 

Overnight visits and/or trips ARE NOTE ALLOWED as per our National Standards and Youth Safety Practices. You will not arrange any overnight activity with your Little Brother/Sister. 

 

You will maintain current liability insurance on any vehicle that you will be traveling in with your Little Brother/Sister.  (Current certificate of insurance must be filed with BBBS.)

 

You will not allow other family members, friends, etc. to transport your Little.  Only the properly screened volunteer may transport the Little. 

 

You will not buy expensive gifts for your Little Brother/Sister unless it is approved by your Case Manager and the parent.

 

You will initiate regular contact with your Match Support Specialist by telephoning the agency on a monthly basis.  Respond promptly to any communication from the agency.

 

You will contact your Match Support Specialist immediately if a problem arises in your match relationship, between your Little Brother/Sister’s parent(s) and yourself, and/or if a situation arises that could endanger the wellbeing of your Little Brother/Sister.

 

You will notify your Match Relationship Specialist if your place of employment, residence, or telephone number changes.

 


Firearms and Weapons Guidelines and Attestation

Firearms

Volunteer must attest to the fact that any weapons, firearms, or ammunition ownership are licensed, permitted, registered, and handled within all state and federal laws. 

 

Weapons, firearms, and ammunition will be made inaccessible at all times to a child while in the Big’s care, unless participating in specific, approved activity(ies), which the Big and parent/guardian have approved in advance and such approval is documented in the match file (e.g., hunter safety courses).

 

Weapons/firearms must be kept by the Big in separate locations from ammunition.

 

BBBS of SWLA will conduct a follow-up home visit annually at the match anniversary with all Bigs who have disclosed at the initial home visit that they own firearms/weapons.