BBBS Volunteer Application

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Non-Discrimination Policy

Our participants come to us with a wide range of personal characteristics. We believe that participant eligibility shall be determined without regard to race, color, religion, national origin, age, gender, marital status, sexual orientation, gender identity and expression, veteran status, disability, familial status, pregnancy, genetic information, or any other characteristic protected under applicable federal, state, or local laws.

Basic Information

Contact ID 18 Character

Enrollment ID 18 Character

Contact Owner ID

Contact Owner Email

First Name

Middle Name

Last Name

Maiden/Alias

input NA if none

Preferred Name

Birthdate

MM/DD/YYYY

Social Security Number

Gender

How do you identify?

Personal Pronouns

What pronouns do you use?

Race/Ethnicity

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

Tribal & Regional Corporation Affiliations

Nationality

To select multiple, hold CTRL/CMD and click.

Relationship Status

Do you have a driver's license?

Driver's License Number

Driver's License State

Driver's License Expiry

Please upload a copy of your license

File can be a screenshot, PDF, or picture

Auto Insurance Effective Date

Auto Insurance Company

Please upload a copy of your auto insurance.

File can be a screenshot, PDF, or picture

Contact Information

Personal Email

Work Email

Alternate Email

Preferred Email

Mobile Phone

Work Phone

Work Phone Extension

Home Phone

Alternate Phone

Preferred Phone

Best Time to Call

In general, do you prefer to be contacted by email or phone?

Mailing Address

Mailing Street Address

Mailing City

Mailing State

Mailing Zip Code

Mailing address is different from residential address

Physical Address

Street Address

City

State

Zip Code

Emergency Contact Information

Name

Phone

Relationship

Are there other adults who live with you?

YesNo

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:

Name

Birth Date

Employer Information

Employment Status

Name of Employer

Occupation

Employment Length (Months)

Employment Length (Years)

Employer Address Line 1

Address Line 2

City

State

Postal Code

Is it okay to call at work?

YesNo

Additional Information

Level of Education

Year Degree Obtained

Education Years Completed (Post high school)

Have you served in the military?

How would you describe yourself, in terms of participation in events, activities, or sports?

Which activities do you enjoy more?

Do you speak any languages other than English?

Spanish	African Languages (Swahili, Bantu)
American Sign Language	Arabic
Asian: Other	Chinese
Creole	Dutch
Eastern European (Czech, Slovak)	French
German	Greek
Hebrew	Hmong
Indian (Hindi, Punjabi)	Italian
Japanese	Keres (West)
Korean	No Preference
Nordic	Persian
Portuguese	Russian
Turkish	Lao

How did you hear about Big Brothers Big Sisters?

Previous Experience

Have you previously applied to be or served as a Big Brother or Big Sister here or anywhere else?

When?

Where?

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.

Spousal/Familial Reference

Spousal/Familial Reference ID

First Name

Last Name

Email

Phone

Relationship to you

Years Known

Professional Reference

Professional Reference ID

First Name

Last Name

Email

Phone

Relationship to you

Years Known

Personal Reference

Personal Reference ID

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

YSO Reference ID

Organization Name

Location

Start Date

End Date (leave blank if still there)

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.
I will be asked to provide my social security number.
I will be asked to provide a photo ID and proof of auto insurance before being matched with a youth.
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 future criminal background and driving records check. Continued involvement will be based on the information discovered.
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.
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.

I accept the terms and conditions

Publicity and promotional materials for Big Brothers Big Sisters are conducted in a variety of forms. By selecting below I authorize Big Brothers Big Sisters to identify me in the media as a Big Brother or Big Sister using my full name. I also give permission for the use of other forms of media including but not limited to written word, photo, video, social media, and voice recording.

PhotoVideoSocial MediaOpt Out

Release of Information Authorization for Background Check

I consent to the preparation and release of background reports to Big Brothers Big Sisters of America and its designated representatives.

Confidentiality Policy

CONFIDENTIALITY POLICY TO BE READ AND SIGNED

BY BIG BROTHERS BIG SISTERS CLIENTS AND VOLUNTEERS

BBBS 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 organization’s professional staff. All records are considered the property of BBBS and not the organization’s staff, clients or volunteers themselves. Records are not available for review by clients or volunteers.

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

Identifying information and/or photos regarding clients and volunteers may be used in BBBS publications, on the organization website or in promotional materials unless the client or volunteer request 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 and volunteer 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 the organization's legal counsel in the event of litigation or potential litigation involving the organization.

State law mandates that suspected child abuse be reported to the appropriate authorities of the Department of Social Services.

If a BBBS staff member receives information indicating that a client or volunteer may be dangerous to himself/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.

At the time a child or volunteer is considered as a match candidate, information is shared between the prospective match parties is confidential. 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, race, religion, interests, hobbies, family situation, etc.

I have read and understand the above information provided to me regarding Big Brothers Big Sisters' confidentiality policy. I agree to program participation under the above conditions.

Policy on Digital Technology and Social Networking

Big Brothers Big Sisters recognizes that online social networking (Facebook, Instagram, Twitter, LinkedIn, TikTok, etc.) are popular communications tools and that many of our participants, both mentors and mentees, use these apps/websites. In general, personal use of social networking sites are for communication between peers, including friends and family. BBBS wants to reiterate that your relationship with your Little is that of a mentor and that not all social networking sites are designed to support mentoring relationships.

Please do not initiate invitations for your Little to connect through social networking sites. It is generally recommended that you have no social media interaction with your Little.

Please proceed thoughtfully if accepting an invitation from your Little to a social networking site. If you have any doubts, please contact your Match Advocate prior to accepting such invitations. If you do choose to participate in a social networking site with your Little, you must adhere to the following guidelines related to your match or affiliation with BBBS.

Matches may participate in communication by email, text, video chat, and phone with parental consent.
Do not participate in any online communication with/about your Little unless you have discussed this with the parent/guardian and Match Advocate and received approval.
Never post any pictures of your Little online unless you have the written consent of the child’s parent/guardian. That consent form should be filed with BBBS.
Never post the last name of your Little, his/her parent/guardian or BBBS staff.
Never post any identifying or contact information about your Little (i.e.: child’s home address, school the child attends, where the parent works, etc.).
Never post anything that could be perceived as judgmental or offensive to your Little or his/her parent/guardian.
Make sure that your page settings are set to private, so that only people you approve can view your online content.
Privacy controls and settings of personal devices should be set to age-appropriate content of your Little prior to any access given to your Little on a device.
Honor confidentiality guidelines within your match; do not post detailed information about conversations with your Little, their parent/guardian or with BBBS staff that would infringe on confidentiality. Posting generalized information or status updates is typically appropriate, but lengthier postings or blogs containing in-depth information should be approved by the parent/guardian and by BBBS prior to posting.
Be aware of other postings on your page that are not BBBS 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 pages.
When in doubt about whether something is appropriate to post, consult with your Match Advocate prior to posting.

If anyone within the match sees social media misuse or content that may endanger the Little’s health, safety, or well-being, that person should contact BBBS staff immediately. Staff will review on a case-by-case basis and take appropriate action regarding any safety concerns.

Please list how you are referenced on social media:

Facebook

Twitter

Instagram

Other

I have read and understand the social media guidelines set by Big Brothers Big Sisters. By signing this document, I am pledging to abide by these guidelines when using social media. I acknowledge that failure to adhere to these guidelines may result in the termination of the match.

Child Safety Guidelines and Ground Rules for Volunteers

The safety of children is our number one priority – no exceptions. Our staff carefully screens each volunteer Big, board member, staff and others who work directly with the children in our programs. As a volunteer Big, it will be your role to make sure the relationship is healthy and that you are making good judgments about the child’s safety on outings. Here’s how you can further promote safety:

· Follow all organizational policies, procedures and ground rules at all times – no exceptions.

· Spending too much time with your Little too early in the match can set an unhealthy precedent for the relationship. Discuss plans and expected time with your Match Advocate.

· Obtain parent/guardian permission for all activities. Be aware that some parents may not be comfortable with your suggestions, so we expect that you will comply with parent decisions. Talk to your BBBS Match Advocate when you have questions.

· Always stay with your Little; do not leave them alone or with someone else.

· Do not use alcohol or other drugs before or during activities.

· Do not use physical discipline or yell at your Little.

· Don’t take others, including your family or friends or the Little’s siblings or friends, on any match outings unless otherwise approved by your Match Advocate and Little’s parent/guardian.

· If an activity involves changing clothes (for example, swimming), there must be separate changing and showering places. If you go on an approved overnight, you and your Little must sleep in separate beds. There are no overnight visits for the first year of the match.

· Never ask the Little to keep a secret.

· Gift giving is discouraged, although you might want to buy an occasional gift for your Little. Seek parental advice about this first.

· Do not engage in tickling, wrestling, giving backrubs, or ask your Little to sit on your lap.

· Seatbelts should always be worn.

· Bigs should never drop off a child at a home where no approved adult is present, or at a location other than where the parent specified.

· Showing age-inappropriate videos, misusing social media, pornography or sexual material is not acceptable and is grounds for match termination.

Required reporting of child abuse and neglect

Big Brothers Big Sisters staff members are required to report any suspected abuse or neglect of a child. Our staff and volunteers are trained to respond if a child tells them about abuse. A report will be filed with authorities. If you have any further questions or would like more information on violence prevention, please don’t hesitate to ask our staff for additional resources. If at any time you suspect that a child is being harmed, either within our program or elsewhere, please contact Big Brothers Big Sisters’ staff.

I have read the above requirements, which define my responsibilities as a volunteer with Big Brothers Big Sisters. I agree to abide by them as long as I am in the program.

Firearms and Weapons Guidelines and Attestation

With the increase in firearm ownership and the number of children who are accidentally shot in homes, we feel obligated to take an aggressive stand for the Littles served by our organization. For that reason, the following three-part firearm policy will be signed by volunteers accepted as Big Brother/Big Sister candidates.

It is the policy of Big Brothers Big Sisters that any volunteer who owns a firearm or has a firearm in her/his home agrees:

1.  To inform Big Brothers Big Sisters of the ownership or presence of weapons or the presence of weapons in the household at any time during the life of the match. BBBS staff will discuss the ownership of weapons during the volunteer interview.   For the purposes of this policy, weapons may include all firearms, handguns, zip guns, knives (except for kitchen knives and small pocket knives not intended for use as a weapon or to inflict bodily injury) and explosive devices.

2.  To attest to the fact that any weapons, firearms, or ammunition ownership are licensed, permitted, registered, and handled in accordance with all applicable state and federal laws.

3.  To ensure that weapons and ammunition are inaccessible to the child assigned to you as a Little and any other child participating on behalf of BBBS Greater Fredericksburg, while the child is under your supervision. Firearms must be inaccessible to a child and ammunition must be securely locked.

4.  To adhere to the policy that a volunteer will not carry a concealed handgun at any time while accompanying the child assigned to your match by BBBS Greater Fredericksburg or while participating in a BBBS group activity. The exception to this will be for law enforcement officers who are required to carry a weapon at all times and have received prior approval from BBBS staff.

4. To understand that the BBBS staff will make the parent/guardian aware of the ownership or presence of a firearm as well as the organization's policy.

5   To obtain permission from the child’s parent/guardian and from BBBS staff before engaging in any activity in which a weapon may be used with the child.

6   To abide by any other policy or procedure that BBBS Greater Fredericksburg may put into effect regarding weapons.

As a volunteer with BBBS Greater Fredericksburg, I understand and agree to abide by the Weapons Policy.

Are there firearms present in your home?

I agree to keep any weapons and ammunition inaccessible to the child assigned to me by BBBS while he/she is in my custody, unless on a specifically approved match activity, such as a hunting trip, a gun safety course, etc that has been approved in advance by the parent/guardian and documented in the match file.

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Contact Information