Guardian/Youth Inquiry Form

Welcome!

Thank you for your interest in Big Brothers Big Sisters.
We are currently enrolling youth ages 8-14.

Steps for Youth Enrollment

1. Complete Inquiry Form
2. Attend Orientation
3. Complete Application and Online Training
4. Schedule Interview (you and your child)

Important Note

****BBBS of Greater Rochester uses email to schedule your Orientation and for communication purposes during the enrollment process. Please be sure to check your email regularly (primary and junk folder).****

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, gender, marital status, sexual orientation, gender identity, veteran status, or disability.

Community Based

Youth Information

First Name

Last Name

Application Name

Concatenated from First + Last

Preferred Name

Birthdate

Gender	Personal Pronouns
How does the youth identify?	What pronouns does the youth use?
Graduation Year This is the year the youth will graduate.

Guardian's Relationship to Youth

The parent/guardian is this child's

Parent/Guardian Information

Parent/Guardian First Name

Parent/Guardian Last Name

Mobile Phone

Personal Email **A valid email address is required for communication purposes**

Contact Preference

Family Information

Which county does your child live in?

County

Mailing Street Address

Mailing City

Mailing State

Mailing Zip Code

Referral Detail ID

Parental Permission

By clicking submit:

I understand that I will be contacted by Big Brothers Big Sisters regarding program enrollment.
I understand that after completing the enrollment process my child may have the opportunity to be matched with an adult mentor who has been screened by a Big Brothers Big Sisters Coordinator.

Contact Information