GUARDIAN APPLICATION




















































Parent/Guardian Preferences:

Big Brothers Big Sisters of the Tri-State does not discriminate against race, age, sex, gender identity or expression, disability, marital status, sexual orientation, religion or national origin. While we honor your preferences, please note that the more restrictions you place on a Big, the longer it may take to match your child.  

Do you have any concerns or preferences regarding your child's potential Big Brother or Big Sister in terms of the following: 







Additional Questions:






Parent/Guardian Permission

I agree to the following:

1. I give permission for my child to participate in the Big Brothers Big Sisters Community, School Based, School Based Plus or Workplace Plus program.
2. I give permission for an agency representative to obtain additional information that may be helpful to the agency’s matching process, this may include information from the school/school board, other social service agencies or counseling references.
3. I understand that information about my child will be shared with a potential Big Brother/Sister and that my child and I will not be identified to a potential Big Brother/Sister until all parties have agreed to the match proposal.
4. I understand that information shared with me about a potential Big Brother or Big Sister will be confidential and I will not discuss such information with anyone other than the Big Brothers Big Sister staff.
5. I agree that a member of the Big Brothers Big Sisters staff will discuss safety with my child and will conduct an age appropriate safety training with them.
6. I acknowledge that the Big Brothers Big Sisters staff is required to report any known or suspected abuse or neglect of my child or occurring within my home.
7. I understand that even if my child is selected to be a part of the Big Brothers Big Sister program that he/she may have to wait for a volunteer mentor and it is additionally not guaranteed that my child will ever receive a Big Brother or Big Sister.
8. I understand that my child’s mentor will have gone through the Big Brothers Big Sisters screening necessary for the program they are applying for which includes at a minimum an in-depth interview, reference checks, and background checks.
9. I understand that when my child is matched to a Big Brother or Big Sister that we all (Big, parent, and child) will be required to do mandatory match support/supervision in order to maintain a healthy, safe and effective match relationship. I understand that a failure to adhere to this supervision schedule can result in the closure of my child’s match. 

Next steps, if you are applying for Community Based matching for your child, upon receiving this application in our office, we will call you and set up a time to come and interview you and your child at your home. If you are applying for School Based matching for your child, when you return this application to the school, the school personnel will notify us, and we will go to the school to interview you child. We will likely be calling you to answer any questions you may have and give you some information on child safety.

Client Statistics 

Parents/Guardians: Please note that this information is confidential and is used only to help us secure funding that will help us continue to serve children. 






























Thank you for filling out the BBBS Guardian Application! A member of our enrollment staff will be in touch soon. We look forward to working with you and your child! If you have any questions please give us a call at (304) 522-2191.