Youth Inquiry

Inclusion Statement

Justice, Equity, Diversity, and Inclusion (JEDI) is an integral part of our values and mission. We recognize, affirm, and celebrate the diverse backgrounds, lives, and experiences of all of our stakeholders, including youth, families, donors, volunteers, and staff. **NOTE: If you are enrolling more than one child, you will need to click "SUBMIT AN INQUIRY FOR ANOTHER YOUTH" AND COMPLETE THE INFOMRATION FOR EACH CHILD. Youth safety is priority at BBBS SWLA. We affirm that your Little's Big Mentor has been thoroughly screened for safety and has been trained in youth safety and compliance.

Youth Information

Child's First Name

Child's Last Name

Child's Preferred Name

Date of Birth

Child's Gender	Child's Personal Pronouns (Optional)
How does your child identify?	What pronouns does your child use?
Child's School	School Account ID
Child's Graduation Year from High School This is the year the youth will graduate.

Child's Race/Ethnicity

Guardian's Relationship to Youth

The parent/guardian is this child's

Parent/Guardian Information

Parent/Guardian First Name

Parent/Guardian Last Name

Mobile Phone

Personal Email

Parent/Guardian Employer (Employer name or NA)

What is the best method for us to contact you?

What is the best day of the week for us to contact you?

What is the best time of day for us to contact you?

Contact Information

Mailing Street Address

Mailing City

Mailing State

Mailing Zip Code

Which Parish do you reside in?:

Referral Detail ID

Which Mentoring Program are you interested in exploring for your child(ren)?
(Mark one, all, or unsure and we will help you decide)

Community Based Mentoring for youth ages 6-18School/Site Based Mentoring (Lunch Buddy and Reading Readiness) for youth in 1st-8th gradeJuvenile Justice MentorU (group mentoring for youth ages for 12-18)Big Futures (High School and Middle School on-campus group mentoring)Unsure of which Mentoring Program I am interested in

How did you hear about us? (Optional: you can include person or place below)

Clicking submit does not automatically enroll and match your child(ren). Program staff will reach out to you via email, phone, or text in order to complete your virtual or in-person orientation, schedule a parent/guardian and youth interview, and finalize all enrollment requirements before your child can be matched.

Contact Information