Youth Inquiry Form

Non-Discrimination Policy

Our participants come to us with a wide range of personal characteristics. Children are not excluded on the basis of race, religion, national origin, color, gender, sexual orientation, disability, gender identity, veteran status, or marital status of parent.

Big Brothers Big Sisters helps children realize their potential and build their future. We nurture children and strengthen communities. The mission at Big Brothers Big Sisters is to create and support one-to-one mentoring relationships that ignite the power and promise of youth.

Thank you for your interest in enrolling your child in our SUCCESS (Students Understanding College and Careers through Education, Skills and Support) program. SUCCESS is for Littles (mentees) grades 8-12 and their Bigs (mentors). SUCCESS, gives Littles experiences focusing on topics such as high school preparation, finding the right college, career exploration, interviewing skills, while providing a mentoring relationship.

As a parent, you recognize the potential of your child better than anyone. By giving him or her the opportunity to connect with a mentor (Big) as part of Big Brothers Big Sisters, you’re creating a path to an even brighter, more promising future.

Could your Child Benefit from having a Big?

It all starts with the right role models and Big Brothers Big Sisters is the place to start a relationship with one. For more than 100 years (over 45 in this region), Big Brothers Big Sisters has recruited, screened, matched, and supported mentoring relationships that have changed the lives of hundreds of thousands of young people across the country.

A national study found that children matched with a Big Brother or Big Sister:

are more confident
are more likely to steer clear of drugs and alcohol
do better in school
get along better with their family and friends
feel better about themselves

Take the next step by completing this inquiry form! More information will follow and the program will begin in the fall. Space is limited and not all inquiries may be accepted.

Please contact me if you have any questions!

Heather Simonson

Senior Program Coordinator

Office: 704.910.1301 ext. 1014

Parent/Guardian Information

Parent/Guardian First Name

Parent/Guardian Last Name

Mobile Phone

Personal Email

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Family Information

Mailing Street Address

Mailing City

Mailing State

Mailing Zip Code

County:

Your County:

Program Options

How did you hear about Big Brothers Big Sisters?

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Referral Detail ID

How can your child benefit from having a Big(mentor)?

What are some of your child’s needs?

Gender	Personal Pronouns
School	Grade/Graduation Year:
Graduation Year from High School This is the year the youth will graduate.

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
Other	Pacific Islander - Chamorro
Pacific Islander - Native Hawaiian	Pacific Islander - Other
Pacific Islander - Samoan	Prefer not to say
White or Caucasian