Volunteer Signature Page
Legal First Name
Legal Last Name
Social Security Number
Statement of Understanding
I understand that:
The references I listed will be contacted by mail, telephone, or email;
The information I provided may be used to conduct a 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;
As per agency policy, the agency is not obligated to give a reason for the decision of not accepting an application;
Other BBBS agencies or youth organizations where I have worked or volunteered may be contacted;
The Big Brothers Big Sisters professional staff may share such information with the other party (ies) where we feel it is in the best interest of the match. While the youth and the volunteer in the potential match are described to each other, no names are used until a match has been agreed to by all persons. Any person in the proposed match has the right to not accept a match upon the information provided;
If I am accepted as a Big Brother/Big Sister, I understand my obligation to meet with my Little Brother/Little Sister regularly and to inform BBBS agency staff as to the status of my match relationship every month. I further agree to accept the supervision of the BBBS staff and discontinue my service if requested to do so by the agency;
I must carry auto insurance at all times on the car that I will be using to transport my Little and must provide proof of auto insurance. If for some reason I do not, then my match may be suspended or closed due to this. Signing below verifies that the submitted auto insurance card covers myself as a driver. I further agree to only drive my Little in the car that is covered by the submitted insurance card.
I have received and will read Big Brothers Big Sisters of Eastern Missouri's confidentiality policy.
Check this box to indicate agreement with above statements.
Type your full name (first and last) to sign.