MentorU Mentor Application 

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Personal Information

Thank you for your interest in becoming a Mentor in our MentorU program. Please complete this application prior to your interview.  At the time of your interview you will need to provide a copy of your Driver's License/Military ID/Government issued ID.

Big Brothers Big Sisters does not exclude on the basis of race, religion, creed, national origin, color, sex, gender identity and expression, familial or marital status, sexual orientation, pregnancy, age, military status, genetic information or any other legally protected status. 























Employment Information 
































Reference Information 

Agency policy requires a minimum of two references from non-relatives (not including partner/relative) who knows you well, preferably two years or more.  

Please be sure to ask your references to respond promptly to our contacts. 
They will be contacted via e-mail and/or phone. 
Professional Reference







Personal, Non-Relative Reference







Partner or Relative Reference

















Education









Miscellaneous Information






Big Brother Big Sisters of the Inland Northwest - Volunteer Agreement

I consent to and understand that:
1)  The reference and youth organizations I listed may be contacted by email, telephone, in-person or by mail; 
2)  The information I provided may be used to conduct background checks, to include a search of public domain records, juvenile and adult criminal history checks, 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 participant's 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 process, 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 and with exceptions noted below;
8)  I understand that incidents of child abuse or neglect, past or present, must be reported to proper authorities; 
9)  I understand that certain relevant information about me will be discussed with the parent/guardian of the child who is my prospective match (this might include 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, new criminal charges, etc.);
11)  I agree to timely communication and follow-up with all agency staff
Please read the following carefully before signing this application: 
I understand this is an application for a volunteer opportunity and is not a promise or commitment by Big Brother Big Sisters (BBBS).
I certify that all information I have provided or will provide to BBBS, including this application is true, correct 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 information contacted on my application will be verified by BBBS. I understand that misrepresentations and 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 BBBS contact person of any and all infractions, violations, charges and convictions related to any civil, domestic or criminal occurrences. I understand that BBBS staff needs to be fully information to provide the best guidance or support possible. 
I understand that BBBS reserves the right to close a Match at any time. 


Br granting permission, I consent to such use of my name and/or pictures in the above marked conditions as long as I remain in the BBBS Program. However, when I do leave the program my photograph will not be used in any future publications but will be used in the present publication until a new publication is produced. I must notify the agency of any changes in release of information. If I do not grant permission, then my name will only be used for internal agency identification of case records. 

If I am the sole or substantial subject of a television, radio, or newspaper promotional, I will need to sign a specific release as required by the media agencies.