Youth Enrollment Form

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Welcome! 

Steps for Youth Enrollment
  1. Watch the Parent/Guardian Orientation video and complete a short questionnaire (10-15 mins)
  2. Complete the Your Child's Personal Safety training (60 mins)
  3. Complete the youth application (5-10 mins per child)
  4. Schedule an interview with us for you and your child(ren) (2-3 mins)
Important Note
**Please be sure to check your primary AND junk email folders for any follow-up material from BBBSM, FormAssembly, or Acuity Scheduling after completing each step of the enrollment process.**
Pre-Screen Questions


Unfortunately, we are unable to continue with the enrollment of this youth. Our program requires youth in foster care to be 7-15 years of age when enrolling.

Please contact our Director of Enrollment, Steven Edge, if you have any questions or concerns at 402-905-3345 or sedge@bbbsomaha.org.

Thank you! Please proceed to the next page.
Unfortunately, we are unable to continue with the enrollment of this youth. Our program requires those enrolling to be 7-14 years of age.

To hear about other local mentoring programs, please contact our Director of Programming and Innovation, Steven Edge, for more information at 402-905-3345 or sedge@bbbsomaha.org.
To enroll this youth, please complete our inquiry form:


You may contact our Foster Care Enrollment Coordinator, Sarah Chevalier, if you have any questions or concerns at 402-905-3348 or schevalier@bbbsomaha.org.

Parent/Guardian Orientation

Thank you for your interest in learning more about joining the Big Brothers Big Sisters' Community-based Program!

Please watch the Parent/Guardian Orientation video and complete the brief questionnaire below it to review what you've learned in the video. Make sure that you find the time and space to do so that will provide you the least amount of distractions.

If you have specific questions about our program or enrollment process, please contact our Director of Enrollment, Steven Edge, at 402-905-3345 or sedge@bbbsomaha.org.
Parent/Guardian Orientation Questionnaire

**Please note that your results may be considered in the acceptance of your child/children.**





Your Child's Personal Safety Training

Course Overview
Nationwide research tells us that children are much more likely to experience violence and victimization than adults. A recent study found that 60% of youth reported having been exposed to violence or victimization in the past year, including sexual victimization.  At Big Brothers Big Sisters we are deeply concerned about the safety and well-being of all children - not only in our local programs, but in their daily lives. This course will increase parents’ understanding of the risks of child sexual abuse and how to recognize the signs of abuse better. 

Estimated time to complete: 1 hour
Additional Resources
Comments/Questions

If you would like to speak directly with one of our staff about this training, please contact Terra Brown, our Director of Belonging and Inclusion, at 402-505-7463 or tbrown@bbbsomaha.org.
Acknowledgement of Completion

Youth Application

Hidden Fields
To look up the owner's email for notifications
For notifications
What You Need To Complete The Application
Please make sure you have the following ready before you proceed:
  • Contact information for an emergency contact
  • Information about your child's medical history
  • Your personal or professional schedule to help you decide on a good date/time to schedule you and your child's interview with us.
  • TIME -- The application should take about 5-10 minutes to complete, but please make sure that you have ample time to complete it. There is an option to save your form if you're unable to complete the application in one sitting.

Youth Information
Enter a date in the following format: mm/dd/yyyy
This is the year the youth will graduate.
**Use the Graduation Year Calculator for assistance**

Press CTRL while choosing to select multiple

Press CTRL while choosing to select multiple

Guardian Information

Press CTRL while choosing to select multiple
Type NA if unemployed
Type to search; please be specific.
Please use their full name, if possible.
Family Information
Physical Address
Number of individuals living in your household
Existing Household Members
Please choose this child's relationship to the following people:


Emergency Contact
Someone other than yourself
Someone other than yourself

Community-Based Program Agreements

Non-Discrimination Policy and Agreement
Non-Disclosure Policy and Agreement
Parent/Guardian Agreement

Confidentiality Policy Agreement

Promotional Authorization

Virtual Platform

Community-Based Program Agreements (Continued)

Girl Scouts Partnership



Girl Scouts Spirit of Nebraska has a partnership with Big Brothers Big Sisters of the Midlands which allows Little Sisters (all grades) to join Girl Scouts and participate in activities and events free of charge! Siblings (kindergarten through 12th grade) can join as well. This applies to all Big Brothers Big Sisters of the Midlands mentees and their siblings in the following counties: Douglas, Sarpy, Cass, Washington, Saunders, Pottawattamie (IA), and Mills (IA).

Through enriching experiences and activities, Girl Scouts discover their values, connect with those who share their vision, and take action to make the world a better place. Girl Scouts is the preeminent leadership development organization for girls, providing abundant opportunities for every girl to do something and be someone amazing!

Girls and their families can choose how to participate, this can be with a troop or as an individual. There are many girls who choose to participate solely by attending programs or a camp. All girls can sell cookies if they desire.

While participating in programs and camps is available at no charge, your girl does need to be registered to participate.
Great to hear!
After you've submitted your Big Brothers Big Sisters application, a representative from Girls Scouts Spirit of Nebraska will contact you within the next month or so for more information on how to get started on registering with them.
No problem!
If you ever change your mind, you can contact us or Girl Scouts Spirit of Nebraska.

Please proceed to the next page.

Additional Enrollments

Next Steps
After completing your e-signature on the next page, you will be re-directed back to a new Youth Application for another child that you would like enrolled in the program. You may click 'Submit' below to proceed.
Next Steps
After completing your e-signature on the next page, you will be re-directed to Acuity Scheduling to set up your interview with us.

Please choose the interview option that best suits the number of children that you are enrolling. You may click 'Submit' below to proceed.