bbbsHigh School Big Application

Welcome!

There is a portion of this application that your parent or guardian will need to complete. We recommend completing the application with them nearby so they can complete their portion as well.

 

Thank you for your interest in volunteering. We receive support from many funders. The information below will help BBBS learn more about our volunteers. If you have any questions, please call 561-727-3450.


Our participants come to us with a wide range of personal characteristics. Participant eligibility shall be determined without regard to race, color, religion, national origin, gender, marital status, sexual orientation, gender identity, veteran status, or disability. 

Hidden Fields




High School Big Contact Information










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High School Big Contact Information


















School and Information




Parent/Guardian Information




Previous Experience



Reference

Please provide the information requested for two references/ recommendations: 
  1. Parent/guardian or adult family member
  2. Teacher, administrator, guidance counselor (no family members) who has known you for at least one year.
Parent/Guardian or Family Reference







Work, School, or Personal Reference







Statement of Understanding

I understand that:


  1. The references listed may be contacted by mail, telephone, or email; 
  2. The applicant is in no way obligated to perform any volunteer services; 
  3. The information provided may be used to conduct an interview, 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 (if applicable); 
  4. The Big Brothers Big Sisters of Palm Beach and Martin Counties (BBBSPBMC) agency is not obligated to match the applicant with a youth or provide specific reasons to me if my application is not accepted; and,  
  5. Should the applicant decide to participate in be accepted into the BBBSPBMC School Based Mentoring Program, we understand that the commitment is for the entire school year.

Confidentiality Policy 

A.   A.  In order for Big Brothers Big Sisters of Palm Beach & Martin Counties to provide a responsible and professional service, volunteers, children and parents or guardians will be asked to divulge personal information about themselves. The agency respects the confidentiality of client and volunteer records, and with the exception of the situations listed below, shares information only among the agency professional staff.

 

1.       For the purpose of program evaluation, audit, or accreditation, certain outside bodies such as Big Brothers Big Sisters of America and grantors, i.e. Children’s Service Council of Martin County, may have access to client or volunteer records.

 

2.       Members of the Board of Directors may have limited and specific access to client files only upon authorization by formal motion of the Board of Directors.

 

3.       Information shall only be provided to law enforcement officials or the courts if subpoenaed.

 

4.       Information shall be provided to the agency’s legal counsel in the event of litigation involving the agency.

 

5.       Suspected child abuse will be reported to the appropriate authorities.

 

6.       If any agency worker receives information indicating that a client or volunteer may be dangerous to himself or others, steps may be taken to protect the appropriate parties.

 

B.   All records are considered the property of the agency.

 

C.   Records are not available for review by clients or volunteers.

Publication/Media Release
I agree to the use of profile information concerning my participation in Big Brothers Big Sisters.  I understand this information may be used for recruitment and development purposes and that it may involve the use of: videotape or still photographs, and/or voice recordings. 
 
I have read and understand the above document which states the agency policy with respect to confidentiality of records and information. I agree to program participation under the conditions it sets forth. 
 
In the event that the applicant is under 18 years of age, it is necessary that a parent or legal guardian sign this release. 

Ground Rules Related to Child Safety and Youth Protection

For School-Based and Community-Based Programs

 

 Prohibited Activities:

    • Overnight Visits
    • Use of Alcohol and Illicit Drugs
    • Non Disclosure of Firearms at enrollment and throughout the life of the match(see Policies/Procedure[i])
    • Non Disclosure of suspected Child Abuse/Neglect  (see Reporting Policy/   Procedure [ii] )

 

  • Transportation 
    • Safety Belts
      • Florida law requires the use of seat belts or child restraint devices by drivers of motor vehicles, all front seat passengers and all children riding in a vehicle under 18.
      • Florida’s safety belt law is a primary enforcement law, meaning that an officer can stop a vehicle and issue a citation simply for observing a safety belt or restraint violation.
      • Children should be in the rear seats until at least age 12, since deployed front seat air bags can be dangerous to children.
    • Child Restraints – Car Seats and Booster Seats
      • Florida law requires children age 5 and under to be secured properly in a crash-tested, federally approved child restraint device.
      • Children ages 0 to 3 must be in child restraint devices of a separate carrier or a vehicle manufacturer’s integrated child seat.
      • Children age 4 and 5 must be in a separate carrier, integrated child seat or booster seat.
      • The best child seat is one that fits your child, fits your car and that drivers will use correctly every time.
      • Read the car seat’s instruction manual and the portion of your vehicle’s owner manual when you install a car seat.
      • Remember to check for car seat and booster seat recalls.

o   School-based mentors are prohibited from transporting children

o   Only assigned and approved Big should transport Little.

    • Firearms are prohibited in any vehicle that is transporting a Little

 

  • Medical Procedures – as outlined in the Authorization for Medical Treatment

 

  • Communication/Parental Approval of all activities
    • Parents/Guardians will be informed and approve all activities in advance
    • Communication should be open at all times between match parties and agency staff (children should never be asked to keep a secret)
    • Respect for all match parties will be demonstrated at all times
    • Emergency contact information will be provided and exchanged between match parties and agency staff.

 

  • Limit Setting through Positive Reinforcement
    • Positive limit setting strategies will be outlined based on the age of the child and any developmental concerns (i.e. ADHD, Special Needs, etc.)
    • Corporal punishment, verbally and/or emotionally abusive means of discipline by Bigs is strictly prohibited and will result in match termination and/or possible reporting of suspected abuse to Florida’s Child Abuse Hotline – if deemed appropriate.
  • Preventing Over-Involvement with the Child and/ or the Child's family
    • Gift Buying should be approved in advance by the parent/guardian with agency staff notified when a gift of an excessive nature is given to a child 
    • Monetary donations or donations for services by the Big to the child’s family should be discussed and approved by the agency’s match support staff in advance
    • Excessive contact over the agreed upon schedule should be discussed with the agency staff (especially critical in the early stages of a match relationship)
    • Involvement of other children on outings should be discussed in advance with the child’s parent/guardian and agency staff 
  • Interactions between volunteers and children will show respect for privacy and personal boundaries.
    • Children have the right to feel safe at all times.  Appropriate and positive interactions between Bigs and Littles are essential in supporting positive youth development and making youth feel valued.  Conversely, inappropriate or harmful interactions can potentially injure a child physically and/or emotionally.  Maintaining a balanced approach to development and monitoring of the match to ensure adherence to agency ground rules in this area is critical to positive youth development and child safety. 

 

    • Agency ground rules surrounding volunteer and child interactions support strategies that help children establish a clear set of personal safety boundaries promoting skill-building that may prevent the child from becoming the victim of violence and/or exploitation (bullying, child sexual abuse, internet exploitation, dating violence, etc.) and/or encourage a child to disclose abuse or victimization.

 

      • Volunteers are encouraged to be sensitive to whether a hug or other form of physical touch would be comfortable to a child or not. School-Based Mentoring must abide by the Code of Conduct of the Palm Beach and Martin County School Districts. 
      • Certain types of physical contact such as: tickling, wrestling, pinching, patting, or asking a child to sit on an adult’s lap are more likely to violate a child’s personal boundaries. 
      • Display or discussion of any materials of a sexual nature is strictly prohibited.
      • Volunteers need to provide separate, private areas for a child to: change clothes, bathe, shower and/or nap.
      • Volunteers should never sleep or nap with a child in the same bed, sleeping bag or couch.
      • Volunteers should never come between a parent and their child; volunteers need to respect a parent’s role and authority.


[i] The American Academy of Pediatrics and the Center to Prevent Handgun Violence recommends the following safeguards if you keep a gun in your home:  always keep your gun unloaded and locked up;  lock and store bullets in a separate location; make sure children don’t have access to the keys; ask police for advice on safe storage and gun locks; the best way to reduce gun risks is to remove the gun from the home.. (1996, 2nd Edition, Keep Your Family Safe from Firearm Injury)Agency policy requires that any

and all firearms in the home be disclosed to agency staff prior to the match and be fully secured.  Firearms are prohibited in any vehicle during transporting of a Little.    

[ii] Volunteers and parents are required to communicate openly with agency staff any concerns for a child’s well-being, up to and including reporting any suspected child abuse to agency staff immediately.  State law  requires mandatory reporting by case managers.  Reports to law enforcement and child protection authorities will be handled by agency

professional staff, in cooperation with the parties involved. 

Parental Permission

Parent Permission
Please hand your device to your parent or guardian so they can complete this page of the application. 

You agree to: 
A. Grant permission for your teen to participate and be interviewed for the Big Brothers Big Sisters mentoring program. 
B. Authorize Big Brothers Big Sisters to secure necessary information regarding your teen from/to: schools, counselors, and service organizations.  
(Note: This consent will expire at the time that your teen is no longer in the Big Brothers Big Sisters program. 
You may revoke this consent in writing at any time). 
C. The use of live camera, video tape or still photographs and/or voice recordings of your teen by Big Brothers Big Sisters for recruitment or development purposes. 

Parent Recommendation
This form is to be completed by the parent/guardian.  Due to the importance of follow through, commitment, and leadership needed in being a role model to younger students, we feel confident you, the parent/guardian will understand the important position this student will have in our program.  It is also important you understand your teen is responsible for his / her own transportation to and from the mentoring site.