Youth Inquiry

Youth Inquiry

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.

Youth Information

First Name

Last Name

Application Name

Concatenated from First + Last

Preferred Name

Birthdate

Gender	Personal Pronouns
How does the youth identify?	What pronouns does the youth use?
School	Graduation Year from High School This is the year the youth will graduate.

School Account ID

Race/Ethnicity

American Indian or Alaska NativeAsian IndianBlack or African AmericanChamorroChineseFilipinoHispanic - CubanHispanic-Mexican,MexicanAmerican,ChicanoHispanic-Other Latinx or Spanish originHispanic - Puerto RicanJapaneseKoreanMiddle Eastern or North AfricanNative HawaiianOtherOther AsianOther Pacific IslanderPrefer not to saySamoanSome other race or originVietnameseWhite or Caucasian

Guardian's Relationship to Youth

The parent/guardian is this child's

Would you like an English or Español

EnglishEspañol

Parent/Guardian Information

Parent/Guardian First Name

Parent/Guardian Last Name

Mobile Phone

Personal Email

I prefer to be contacted by

Family Information

Which community are you enrolling your youth in?

Agency Location ID

NOTE for BBBS staff (delete before making the form live): You will need to update the drop down above with the corresponding location options for your agency. Once you've added the locations available to your chapter, click on the Options button for the dropdown, go to the Calculations section in the left panel, and input the Agency Location IDs for each.
IF YOU HAVE ONLY ONE LOCATION, YOU CAN DELETE BOTH THE DROPDOWN AND TEXT BOX BELOW IT AND JUST MAP THE ONE ID IN THE CONNECTOR

Mailing Street Address

Mailing City

Mailing State

Mailing Zip Code

County:

How did you hear about Big Brothers Big Sisters?

Referral Detail ID

Contact Information