Mentor Application

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Mentor Information

Hidden Fields





Hidden Fields









xxx-xxx-xxxx








Demographic information is collected to honor parent preferences and allows us to make matches based on shared life experiences. We are an inclusive organization and celebrate diversity!








Emergency Contact Information


xxx-xxx-xxxx

Pre-Interview Questions

Due to the nature of our program, Big Brothers Big Sisters of Snohomish County must take great care in the screening of prospective volunteers. Parents of youth in our program often ask questions about volunteers with whom their child will be matched. It will help us make a better match for you and assure we can support you during your involvement with our programs. The following information is provided so that you may make an initial determination as to your eligibility. The right to refuse the application of any person rests solely with the agency and is determined by the professional staff that it employs. The refusal of a particular application may include areas which are not listed below.  Big Brothers Big Sisters of Snohomish County does not discriminate on the basis of race, sexual orientation, gender identity or religion.










Program Interest

Please check off the programs you are interested in:






Background Checks







XXX-XX-XXXX

Photo Identification & Auto Insurance



MM-DD-YYYY






MM-DD-YYYY

MM-DD-YYYY

Alternative ID


Mentor References

We require three references to become a mentor in addition to references from youth serving organizations you have been involved with in the last 5 years. 
Employer/Coworker Reference






# years
Significant Other Reference - if no Significant Other please list another Friend/Family Member






# years
Personal Reference






# years

Mentor Application - Policies

Media Release Agreement

Sharing stories and celebrating your success is an important part of our mission!


I hereby authorize Big Brothers Big Sisters of Snohomish County to use my image, voice and/or performance for publicity purposes to promote the Big Brothers Big Sisters program.  I agree that there will be no compensation whatsoever for this participation or for the use of resulting materials by Big Brothers Big Sisters.  I further agree that this participation confers no ownership rights.  I understand that no personal history information will be revealed by the agency. From time to time stories may  be shared through our national organization.


Confidentiality & Reporting Neglect or Abuse Policy
As a volunteer Big Brother or Big Sister, I understand that personal information about the Little I am matched with, and/or his/her family, should be held in confidence.  I understand that this confidentiality policy does not include my Case Manager or other Big Brothers Big Sisters agency staff who I might speak with regarding any circumstances of my match. Information that I share with people I know will be limited to information about the types of activities that my Little and I do together and will not reveal personal information that my Little shares with me.  When speaking to people I know about my Little, I will only use his/her first name and will not identify where my Little lives.

 

Reporting Abuse and Neglect: I will contact my Case Manager immediately if my Little shares any information regarding abuse or neglect or if I suspect any abuse or neglect.

 

I have read the above statement and understand Big Brothers Big Sisters of Snohomish County's policy regarding confidentiality of my Little’s personal life.  I agree that I will fully adhere to the terms of the policy as a condition of my involvement with the agency, and understand that failure to comply with this policy may result in a severance of my relationship with the agency.  This statement shall remain in full force and effect for the entire duration of my involvement with Big Brothers Big Sisters of Snohomish County and thereafter.


Firearm Agreement


I will inform agency staff if I or someone I live with acquires a firearm (or an additional firearm) throughout any point of my involvement with the agency, and I agree to abide by the firearm storage agreement. 

 

As a volunteer Big Brother/Big Sister, I agree to keep all firearms/weapons that may be in my home inaccessible to my Little.  I will do this by assuring that the following precautions are taken:

  • All firearms/weapons in my household will be unloaded, locked-up, and inaccessible to my Little.

  • All firearms in my household are registered when legally required.

  • Any bullets or ammunition in my household will be locked-up separately from the firearms/weapons and will be inaccessible to my Little.

  • My Little will have no knowledge of firearms/weapons being stored in my home.

  • I will not carry a weapon on me during any match activity with my Little.

  • If I am a site-based Big Brother/Big Sister, I will not bring a weapon with me when I visit my Little at the site.

  • BBBSSC will consider waiving this for certain occupations (eg: police officer).

I realize that if there is a firearm/weapon in my household, even if I am not the owner, I am responsible for taking these safety measures throughout the duration of my match.  I understand that this agreement may be discussed with the Little’s parent or guardian in the match proposal call, and will be monitored by my Case Manager in follow-up calls.


Home Visits Policy

Visits to the volunteer’s home are strictly prohibited in the first 3 months of a Community-based match.  Parent/Guardians are not permitted to allow home visits within the first 3 months of the match.  After 3 months, volunteers must have the consent of the Parent/Guardian in order for home visits to occur on outings and should consult with their Case Manager prior.  Any violation of this policy could result in immediate closure of the match.

 

Site-based program – activities outside the designated location (school or workplace) are prohibited including visits to the mentor’s home.


Overnight Activities Policy

BBBS of Snohomish County prohibits overnight visits. Exceptions to this policy are permitted in cases where one of the following specific criteria have been met AND the required authorizations have been documented:

 

  • There is genuine concern for the safety of a child returning to their own home (emergency circumstances

OR

  • An event is formally designated by the agency as one that (1) is of a nature to provide an exceptionally significant developmental or educational benefit to a child or youth, and (2) that the event would not be possible without the Big accompanying the Little (a college visit for example)


Digital Technology & Social Media Policy
Big Brothers Big Sisters of Snohomish County recommends that Bigs do not communicate with their Littles via social media; however, if they choose to do so, the Little must be at least 13 years of age and given permission by Parent/Guardian.

Updated Background Checks Policy
I agree to inform Big Brothers Big Sisters staff of any involvement that I have with law enforcement for the duration of the time that I am matched in the program (this includes speeding violations).  I understand that Big Brothers Big Sisters will run a background check on me every 3 years (minimum) that I am matched in the program. Staff will use professional judgment on whether any accusations or charges warrant closure of the match.

Insurance Coverage & Accident Policy

Insurance Coverage

Volunteers should maintain minimum limits of auto liability coverage. It is very important – for your liability and for the agency’s – that you have the minimum coverage. In the event that minimum coverage is not met volunteers should discuss this with agency staff and a decision will be made regarding ability to participate in the community-based program where driving might occur. 


1.   I affirm that I have and will maintain Personal Auto Liability Insurance with the limits of at least $25,000/$50,000 Bodily Injury and $25,000 Property Damage (or $100,000 Combined Single Limit).

2.   I will supply a copy of my up to date auto insurance card when requested by Big Brothers Big Sisters of Snohomish County.


If I am a site-based Big Brother/Big Sister, I understand that I am not allowed to transport my Little at any time.

Release of Liability/Participation

I am an adult age 18 or older and wish to participate in YMCA/BBBS activities. In addition, if applicable, I give permission for my dependents to participate in YMCA/BBBS activities. I understand that accidents can sometimes happen. Therefore, in exchange for the YMCA/BBBS allowing me, and if applicable, my spouse and my dependents to participate in YMCA/BBBS activities, I understand and expressly acknowledge that I release the YMCA/BBBS, its employees, its boards, members, volunteers or guests from all liability for any injury, loss or damage connected in any way whatsoever to participation in YMCA/BBBS activities whether on or off the YMCA’s/BBBS’ premises and including transportation. I understand that this release includes any claims based on negligence, action or inaction of the YMCA, its employees, boards, members, volunteers or guests.


Small Group Mentoring Agreement
If I choose to participate in the Small Group Mentoring (SGM) program I understand that:
  1. I have made a commitment to attend at least six (6) activities per year (SGM 12+ or SGM Under 12), unless matched in a Community-Based or School-Based match during that year. If I do not fulfill that commitment, I may be considered an inactive volunteer and my file may be closed.
  2. I further understand that -- like my matched counterparts -- I will be required to undergo annual background checks. In addition, I will follow mandatory Match Support Contacts requirements by communicating with a Case Manager at least every ninety (90) days.
  3. I affirm that -- as a SGM Big -- I will NOT meet or communicate with any of the Littles except during SGM activities or BBBS events. This includes no in-person, telephone, letter, email, and/or internet-related activities (such as Facebook and other on-line social media sites).
  4. If I am interested in becoming a Community-Based Big, I will contact the agency and inform them of my decision. I understand that additional steps will need to be taken to fulfill requirements for a Community-Based matched.

Interest Checklist











Mentor Consent

Recognizing that the primary purpose of Big Brothers Big Sisters of Snohomish County is to serve youth, I understand that:

  • Big Brothers Big Sisters of Snohomish County is not obligated to assign me to a match.

  • I am not obligated to accept a match when it is proposed by the agency staff; however, once a match is accepted, I understand that I have made a one-year commitment to the youth I have accepted and to Big Brothers Big Sisters of Snohomish County.

  • The information I provided may be used to conduct a background check, to include driving records check, criminal background check, and other records where required by local, state, or federal law for volunteers working with youth.

  • I must inform agency staff of any involvement that I have with Law Enforcement during the duration of my match.

  • As part of our enrollment processes, we will be asking you to provide additional personal information prior to making any recommendations for assignment.

  • The preferences of a youth’s parent or guardian are respected in selecting a mentor.

I acknowledge and agree that, for the duration of my involvement with Big Brothers Big Sisters of Snohomish County any information I share with a staff member, including personal, health, or other information may be shared at the discretion of the agency staff with potential Little Brothers/Little Sisters and parent/guardian, and with the Little Brother/ Little Sister eventually selected for me and the parent/guardian, unless I specifically request otherwise. However, the names of the parties described shall be held confidential until the match is accepted by both parties.

 

I agree to adhere to the terms of Big Brothers Big Sisters of Snohomish County policies and practices as presented to me by agency staff, and understand that failure to comply with agency’s policies and practices may result in a severance of my relationship with the agency.

 

I understand that Big Brothers Big Sisters of Snohomish County is not liable to give reason(s) of non-acceptance.

 

I understand that records are not available for review by clients, parents/guardians, and/or volunteers.

 

I agree to program participation under the conditions above.


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