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

Basic Information








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Contact Information

























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Additional Information






References and Background Check

Previous Experience










Volunteer Experience











Please provide at least three references below including:
  • Your spouse or domestic partner OR a family member if you do not have a spouse, partner, or significant other.
  • Current or former employee or co-worker you have known for at least one year or someone from your school if you are a student
  • A friend or neighbor you have known for at least two years
Spousal/Familial Reference







Professional Reference







Minimum 1 year
Personal Reference







Minimum 2 years
I consent to and understand that:
  1. The references and youth-serving organization(s) I listed may be contacted by mail, telephone, email, or in person;
  2. The information I provided may be used to conduct a background check, to include a search of public domain records, driving records check, juvenile and adult criminal history check (see attached authorization), military records, and other records where required by local, state, or federal law for volunteers working with youth;
  3. I am in no way obligated to perform any volunteer services;
  4. The BBBS agency is not obligated to match me with a youth and may deny my application or close my match at any time, and to protect all participants’ confidentiality, BBBS is not required to disclose reasons for doing so; 
  5. Other BBBS agencies and youth organizations where I have worked or volunteered may be contacted as references;
  6. As part of the enrollment processes, I will be required to provide additional personal information, including completion of an in-person interview;
  7. I understand that the information I provide in the enrollment process will be kept confidential, unless disclosure is required by law.  
  8. I understand that detailed accounts of child abuse or neglect, past or present, will be reported to proper authorities;
  9. I understand that certain relevant information about me will be discussed with the parent/guardian of a child who is a prospective match (this might include demographic information, information relevant to parent/child preferences, and any information relevant to a child’s safety or well-being);  
  10. It is my responsibility to update the agency if any of the information I provide on this application, in my interview, or any other information provided during the enrollment process changes (i.e. address, phone number, auto-insurance, new criminal charges, etc.)
  11. I agree to complete questionnaires throughout my time in the program to evaluate and improve program services;
  12. I agree to timely communication and follow-up with all agency staff as required by the agency.

Pre-Interview Questionnaire

Prior to your in-person interview, please answer the questions below. The information you provide will also help us make a better match for you and assure we can support you during your involvement with our program. Please note that you will have an opportunity to discuss these questions and your responses more thoroughly during your in-person interview.  





Agency Weapons Policy

Policy on Firearms and Weapons

  • Any weapons/firearms owned or in the home of the Big/Volunteer must be disclosed to the Agency at the time of enrollment and if acquired during the life of the match.
  • Weapons/firearms and ammunition must be locked in a safe or room which is not accessible by the Little at any time.
  • The Big’s/Volunteer’s possession of firearms will be disclosed to the child’s parent/guardian.
  • Bigs/Volunteers must attest to the fact that ownership of the weapons, firearms, and/or ammunition is licensed, permitted, registered, and handled in accordance with all applicable state and federal laws.
  • Activities involving firearms or weapons are strictly prohibited as a part of match outings. Weapons/firearms will be made inaccessible at all times to the Little while with the Big or under the Big’s/Volunteer’s care.



Please provide the name, age, and relationship to you for anyone else residing in your home. Please put N/A if no one else resides in your home in both  name and birth date.


Release of Information Authorization for Background Check

BACKGROUND CHECK CONSENT FORM

 

 

I do hereby authorize Big Brothers Big Sisters of Summit, Medina and Stark Counties to obtain a set of impressions of my fingerprints, conduct a criminal records check with respect to me and to request any City, County, State or Federal Bureau, Department or Agency to furnish any information in their files under the above name and information.  I agree to hold Big Brothers Big Sisters and any other source of information blameless for any error in reporting this information.  I release Big Brothers of Summit,  Medina and Stark Counties and all other persons whomsoever from any damage on account of furnishing said information whether or not final disposition is known.

Confidentiality and Digital Platform Policies

CONFIDENTIALITY POLICY

(To be read and signed by agency clients and volunteers)

Access to Confidential Records

In order for BB/BS to provide a responsible and professional service to clients, it is necessary for volunteers, clients, and their parents/guardians to be asked to divulge extensive personal information about themselves and their families. The agency 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 agency professional staff and with potential matches. The right to confidentiality applies not only to written records, but to video, film, pictures or use of client or volunteer names in agency publications.

All records are considered the property of the agency and not the agency staff, clients, or volunteers themselves. In order to provide agency services, information from outside sources including confidential references, must be assessed along with information gained from the clients or volunteers themselves. Clients, parents/legal guardians, volunteers, board members, Big Brothers Big Sisters of America and its agents shall sign a statement that he/she has read and understands the agency policy on confidentiality and agrees to program participation under the guidelines it sets forth.

Limits of Confidentiality

1.        Except as specified below, information will be released to other individuals or organizations only upon presentation of an authorized “Consent of Release of Information” form appropriately signed by the client or volunteer.

 

2.       Members of the Board of Directors and certain outside bodies such as Big Brothers Big Sisters of America may have access to client files and volunteer records for the purpose of program evaluation, audit, or accreditation. Such persons shall be required to sign a confidentiality statement at the time of access. Known violations of agency confidentiality policy will be reported to the supervisor of the individual involved and disciplinary action shall be requested.

3.       Information shall be provided according to law or valid court order.

 

4.       If an agency worker receives information indicating that a client or volunteer may be dangerous to himself/herself or other, necessary steps may be taken to protect the appropriate party. This may include a medical referral or a report to local law enforcement.




SOCIAL MEDIA POLICY

Big Brothers Big Sisters of Summit, Medina, and Stark Counties (BBBS) recognizes that social networking on the internet is prevalent for volunteers, mentees, and mentee’s families. To protect our children and their families, we expect volunteers to adhere to the following BBBS Social Media Policy, to ALL guidelines defined by social media sites, and to ALL state and federal laws. BBBS reserves the right to monitor the social networking activities of volunteers, and to request that a volunteer delete inappropriate information from a social media site. If a volunteer is seen using social media in an excessively inappropriate manner, his or her relationship with BBBS and their Little could be terminated.

School-Based Matches:

A school based mentor may never initiate or accept an invitation to “connect” or “follow” his/her mentee or mentee’s family on any social media site. School-based mentors and their mentees are not allowed to communicate outside of the guidelines of the School-based program. THIS INCLUDES NETWORKING ON SOCIAL MEDIA PLATFORMS. Additionally, School-based mentors are prohibited from taking photos and/or videos of their mentee at any time.

Community-Based and Dual Matches:

        I.            Child Safety and Appropriate Networking on Social Media

Child safety is our first priority. Volunteers choosing to engage in social media are expected to maintain an appropriate presence on social media, even if they are not “connected” with their mentee through social media sites. Volunteers serve as role models for the child and the community.

·       Volunteers should ensure that posts, tweets, photos, and comments are appropriate and child friendly.

 

      II.            Confidentiality and Privacy

BBBS requires its volunteers to respect the confidentiality and privacy of the Littles, children, and families of BBBS in every respect, including in social media. This applies even if the volunteer is not associated with the mentee through social media sites. Volunteers must follow these requirements regarding confidentiality on their own and other’s social media sites.

·       Written parental permission is required to post, share, or tweet, photos or videos of a Little.

·       Never post, share, tweet, or tag a Little’s full name, location, city, address, school or other personal information such as where his or her guardian works.

·       Volunteers should not use geo-posting applications when they are with a Little.

 

   III.            Associating with Littles Through Social Media

Volunteers in a Community-based or Dual-match may not initiate or accept an invitation to associate (e.g. connect or “follow”) his/her Little or members of the Little’s family on any social media site without written parental permission (parents will be given the opportunity to consent or deny consent during the enrollment process). Once a volunteer has associated himself/herself with a Little or a member of the Little’s family on any social media site, the volunteer must grant the same association to BBBS or any member of its staff as requested by BBBS.

Procedure

Volunteers: The Social Media Policy will be provided to Community-based and School-based Bigs/Volunteers with the application. The Applicant will sign the Guidelines and bring the signed copy to their interview along with their application.

During the Applicant interview, highlights of the Guidelines will be reinforced. A copy of the signed Guidelines will be placed in the file along with the application.

Littles: For Community-based matches, BBBS will share highlights of the Guidelines with Parent(s)/Guardian(s) during the enrollment process and during match introductions.

Violations of this policy will be handled by match support. In any case where a volunteer and/or Parent/Guardian do not comply after an initial conversation with match support, the violation will be escalated up to either the Community Based Program Manager or the Site Based Manager and the volunteer’s relationship with BBBS could be terminated.

Virtual Platform


Media Consent and Release

I irrevocably consent to any and all uses and displays of my name, image, likeness, appearance, basic biographical information, audio/video recordings, writings, artwork, and the like, in original form or in modified form, in whole or in part, in, on, or in connection with merchandise, advertising, publicity, marketing, fundraising, and the like, in printed or electronic media, of any type, throughout the world at any time by Big Brothers Big Sisters of America and [BBBSA affiliate] in their sole discretion, and by any of their affiliates, successors, partners, sponsors, donors, any entities or persons with whom they conduct any public relations, marketing, or fund raising of any type, and any other authorized third parties, without further consent from me, without any royalty, payment, or other compensation to me, and with the release and waiver of any claims, actions, damages, losses, costs, expenses and liability of any kind arising from any such use (the “Released Material”).
In consideration of the mutual promises made herein, and for other good and valuable consideration, the receipt and sufficiency of which I hereby acknowledge, I hereby grant to BBBSA and its affiliates the right to use the Released Material as BBBSA and/or its affiliates may desire, in all media now existing or hereafter created and in all variations and forms including, but not limited to, internal or external publications or productions, informational or recruitment materials, marketing materials, fundraising materials, televised photography and/or recordings, advertisements, Public Service Announcements, and/or online and social media sites. The use of this information shall be at the sole discretion of BBBSA and/or its affiliates.

I further grant to BBBSA and its affiliates the absolute right to use the Released Material in whole or in part, alone or in conjunction with any other image, name, writings or reproduction, in color or otherwise, for art, advertising, business, trade, or any other lawful purpose whatsoever, in perpetuity throughout the world.

I understand and agree that all materials created by BBBSA and/or its affiliates that use the Released Materials are the property of and are owned by BBBSA, and that I cannot authorize their use by any other party.  I further understand that BBBSA may authorize their use by a third party. I hereby irrevocably transfer and assign to BBBSA my entire right, title and interest, if any, in and to the Released Materials and all copyrights in the Released Materials arising in any jurisdiction throughout the world, including the right to register and sue to enforce such copyrights against infringers.

I acknowledge and agree that I have no right to review or approve the Released Materials before they are used by BBBSA and/or its affiliates, and that BBBSA has no liability to me for any editing or alteration of the Released Materials or for any distortion or other effects resulting from BBBSA’s and/or its affiliates’ editing, alteration or use of the Released Materials.  BBBSA has no obligation to use the Released Materials or to exercise any rights given by this Consent and Release Form.

I hereby release BBBSA and its affiliates, employees, and agents, as well as any partner companies, from all claims, demands or liabilities and related financial costs that I may now or hereafter have arising in connection with BBBSA’s exercise of the rights hereby granted, and/or with the appearance or the Released Materials in any publication or production. These include, without limitation, claims for compensation, defamation, or invasion of privacy, or other infringements or violations of personal or property rights of any sort whatsoever.

Child Safety Guidelines and Ground Rules for Volunteers                                                                      


MATCH AGREEMENT & GROUND RULES

Community Based Program

 

Match Support Team Agreement: The role of the Match Support Specialist (MSS) is to support the match, to monitor the match for safety and healthy relationship development, and to keep the match informed of BBBS events and activities. In order to provide you with the best possible customer service, we agree to these terms:

  • We will be available by phone and email to respond in a timely fashion to any of your needs or concerns.
  • We will professionally monitor and assess your match for healthy development and will assist you if difficulties arise.
  • We will support your progress and identify areas of growth.
  • We will provide ideas and activities for matches to do together every month. These will be low cost, fun and educational.
  • We will offer training opportunities and resources for Volunteers, Parents/Guardians and Littles.
  • We will provide you with a Match Plan at the beginning of the match of the Match and we will work with you to revise the Match Plan at the three and six month anniversary of your match and at least annually thereafter.
  • We will conduct satisfaction surveys and program outcome evaluations, to gain your ongoing feedback of our program.

 

Volunteer Agreement:

  • I will commit to seeing my Little consistently and regularly.  I will not see my Little more than once a week. I will discuss specific circumstances that warrant additional visitation with my MSS.
  • I will initiate contact with my Little by telephone. Match activities will be arranged by me, in advance, and in consultation with the Parent/Guardian.   
  • I will not include other adults and children on outings with my Little without the prior approval of my Match Support Specialist.
  • I will never leave my Little unsupervised or with someone else.
  • I will comply with the BBBS Home Visit and Overnight Policy & Agreement. I will not bring my Little to my home during the first twelve (12) months of my match; and I will not have overnight visits during the first two years.  I understand that overnight visits will be discussed after the match has successfully passed the two year anniversary mark and I have adhered to all of the appropriate terms of the match. I will not discuss home visits or overnights with the Little or the parent before I have had a discussion with the BBBS Match Support Specialist and been given the approval to proceed.  
  • I will plan safe and appropriate activities for my Little.  These activities can be BBBS events or any other free or low-cost activity.  I realize that I am responsible for the cost of any activity that I choose to engage in with my Little. I will keep the money that I spend on our outings to a minimum.
  • I will not give my Little or the Parent/Guardian any money. Gifts for my Little will be limited to birthdays or special holidays, and will not be excessive. 
  • If there are things I need to discuss with the Parent/Guardian, I will do so in private, and not in front of my Little.  If a problem arises between the Parent/Guardian and me, I will contact my Match Support Specialist immediately.
  • I will communicate monthly with my Match Support Specialist and will respond to all phone calls, emails or letters from agency staff.  When requested, I will complete all surveys and evaluations in a timely manner.
  • I understand that I will be required to meet with my MSS and my Little and Parent/Guardian in person at our six and twelve month match anniversary and annually thereafter. I also understand and agree to meet with my MSS, my Little and Parent/Guardian at any time my BBBS MSS feels it is appropriate. I understand that compliance with this policies is required in order to continue my match relationship.
  • I understand I will be responsible for working on my match goals as initially established and being an active participant in setting new goals at the three and six month anniversary of my match and at least annually thereafter.
  • I understand that the following objectives are the overall goals of BBBS and will make every effort to insure that my match relationship with my Little is working toward these objectives.
    1. Successful completion of the 3rd grade reading proficiency tests
    2. Successful completion of the 8th grade math proficiency tests
    3. Graduation from high school and receipt of high school diploma
    4. The development of a 13 year plan that supports education, military service, career training or other activities that will provide for financial independence.
  • When I realize that if/when my match needs to end, I will contact my Match Support Specialist immediately. I understand that I will be actively involved in the closure of my match and I will commit to ending the match in a way that will be best for my Little and myself.

 

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Parent/Guardian Agreement:

  • I agree to let my child see the Big consistently.  I will not allow my child to see the Big more than once a week unless the need has been specifically discussed with my MSS and approved.
  • I understand that I am an active partner in my child’s relationship with a Big Brother/ Sister and that I play an important role in keeping my child safe.
  • I understand that the match is a friendship between my child and the Big. I will not ask for special favors from the Big. My child is the only person who can go on outings with the Big unless my Match Support Specialist gives permission for another adult or child to join the match on an outing.
  • I will be involved in the planning of all match activities and outings but ultimately, I will allow the match to make their final plans.  I will be flexible with family plans so they do not interfere with the match relationship.  If I am not comfortable with a selected activity, I will discuss it with the Big or my Match Support Specialist. 
  • I will contact the Big immediately if my child will not be able to go on a planned outing.
  • I will have my child appropriately dressed, fed, and ready on time for each outing.
  • When my child returns from outings, I will have a detailed discussion with him/her about what the match did together and how the outing went.  
  • I will discourage my child from asking for presents, special treats or expecting expensive outings. I am welcome to send money along with my child on each outing.
  • I will make arrangements with the Big if I cannot be at home when my child is to return from outings.
  • I will return all phone messages/texts/emails from the Big, and will ensure that my child will do so as well.  If there are things I need to discuss with the Big, I will do so in private, and not in front of my child.  If a problem arises between the Big and me, I will contact my Match Support Specialist immediately.
  • I will not use time with the Big as a reward or a punishment for my child. I will not restrict my child from seeing the Big but I may restrict outings to only include educational or service-oriented activities, if necessary.  If I am having difficulties with my child, I will communicate them to the Big and the Match Support Specialist so that a plan for improvement can be developed.   
  • I will communicate regularly with my Match Support Specialist and will respond to all phone calls, emails or letters from agency staff.  When requested, I will complete all surveys and evaluations in a timely manner.
  • I understand that I will be required to meet with my MSS and my child’s Big in person at the six and 12 month anniversary of the match and annually thereafter. I also understand and agree to meet with my MSS and my child’s Big any time my BBBS MSS feels it is appropriate. I understand that compliance with this policy is required in order to continue the match relationship.

 

  • I understand I will be responsible for working with my child and their Big to meet their match goals as initially established and being an active participant in setting new goals at the three and six month anniversary of the match and at least annually thereafter.
  • When I realize that my child’s match needs to end, I will contact my Match Support Specialist as soon as possible. I will end the match in a way that will be best for my child and the Big.

 

Child/Youth Agreement:

  • I agree to see my Big on a regular basis. I will not ask to see my Big more than once a week.
  • I understand that to have a friend I have to be one:
    1. I will talk to my Big and help plan our activities together and I will be open to trying new things.
    2. I will use good manners, always be on my best behavior and will remember to say thank you for outings.
    3. I will be ready on time for our scheduled outings.
    4. I will not ask to bring friends or family members along on activities with my Big.
    5. I will not expect my Big to spend money on me or buy me things.
    6. I will not ask to spend the night at my Big’s house.
    7. I will ask for my Big’s phone number and will try to call/text them.  I will always return calls/texts from my Big immediately.
  • I will always tell my Parent/Guardian about the plans I make with my Big.
  • When I return from an outing with my Big, I will talk to my Parent/Guardian about what my Big and I did together and what I thought (or how I felt) about the outing.
  • I will talk regularly with my Match Support Specialist to tell them about my match.
  • I will not keep secrets about the match from my Parent/Guardian or my Match Support Specialist.
  • I will tell my Parent/Guardian or Match Support Specialist if I am uncomfortable or have a funny feeling about anything that happens with my Big.

Application Acknowledgement

I understand that this is an application for a volunteer opportunity and is not a promise or commitment by Big Brothers Big Sisters.

I certify that all information I have provided or will provide to Big Brothers Big Sisters, including this application, is true, accurate, and complete to the best of my knowledge. I certify that I have and will answer all questions to the best of my ability and that I have not and will not withhold any information that would affect my application for a volunteer position. I understand that information contained in my application will be verified by Big Brothers Big Sisters. I understand that misrepresentations or omissions may be cause for my immediate rejection as an applicant or my termination as a volunteer.

At any time while involved with the Big Brothers Big Sisters program, I agree to immediately inform my Big Brothers Big Sisters contact person of any and all infractions, violations, charges, and convictions related to any civil, domestic, or criminal matters.  I understand that BBBS staff needs to be fully informed to provide the best guidance or support possible.  

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