High School Big Application

Program Information

Welcome to the High School Bigs Program application, hosted by Big Brothers Big Sisters of the Tennessee Valley. This program pairs high school student volunteers with younger elementary school students for weekly one-on-one mentoring during the school day. Applicants must have good standing in attendance, grades, and behavior, and 2–3 references. A completed parent or guardian permission form is required to apply. Qualified applicants will attend a BBBS orientation and complete a volunteer interview before being matched. This online application may be completed by the high school volunteer, but please note that a separate parental permission will be required for all students to participate in the program.

Contact Information

Personal Email

School Email

Alternate Email

Preferred Email

Mobile Phone

Work Phone

Work Phone Extension

Home Phone

Alternate Phone

Preferred Phone

Best Time to Call

In general, do you prefer to be contacted by email or phone?

Mailing Address

Mailing Street Address

Mailing City

Mailing State

Mailing Zip Code

Mailing address is different from residential address

Physical Address

Street Address

City

State

Zip Code

Emergency Contact Information

Name

Phone

Relationship

Employer Information

Employment Status

Name of Employer

Occupation

Employment Length (Months)

Employment Length (Years)

Employer Address Line 1

Address Line 2

City

State

Postal Code

Is it okay to call at work?

YesNo

Previous Experience

Have you previously applied to be or served as a Big Brother or Big Sister here or anywhere else?

When?

Where?

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.

References and Background Check

Please provide at least two references: A Parent/Guardian Reference and a School Personnel (teacher, coach, counselor, etc.).

Familial Reference

Spousal/Familial Reference ID

First Name

Last Name

Email

Phone

Relationship to you

Years Known

School Personnel Reference

First Name

Last Name

Email

Phone

Relationship to you

Years Known

Have you held a volunteer or paid position where you worked with children in the last five years? (for example counselor at a camp, babysitting, nannying, coaching, etc.)

Volunteer Experience

Organization Name

Location

Start Date

End Date

Direct Supervisor First Name

Direct Supervisor Last Name

Phone

Email

Years Known

Reason for Leaving

I understand that:

The references and youth organizations that I have worked for or been involved with as a volunteer whose information I have provided may be contacted by telephone or email.
I am in no way obligated to perform any volunteer services.
I will be asked to provide my social security number.
The information I provide may be used to conduct a background check, to include a driving records check, criminal background check, and other records where required by local, state, or federal law for volunteers working with youth. If matched, the information I provided may also be used to conduct an annual criminal background and driving records check. Continued involvement will be based on the information discovered.
Big Brothers Big Sisters has the right to accept or deny program participants and is not obligated to match me with a youth. Big Brothers Big Sisters is not required to provide me with a reason if I am not accepted or matched with a youth.
As part of the enrollment process, I agree to provide additional personal information to assist Big Brothers Big Sisters in making a recommendation for matching.

I accept the terms and conditions

Publicity and promotional materials for Big Brothers Big Sisters are conducted in a variety of forms. By selecting below I authorize Big Brothers Big Sisters to identify me in the media as a Big Brother or Big Sister using my full name. I also give permission for the use of other forms of media including but not limited to written word, photo, video, social media, and voice recording.

PhotoVideoSocial MediaOpt Out

Confidentiality Agreement

Big Brothers Big Sisters of the Tennessee Valley respects the confidentiality of client and volunteer records and, with the exception of situations listed below, shares information about clients and volunteers only among the agency professional staff.

All records are considered the property of the agency and not the agency workers or clients or volunteers themselves. Records are not available for review by the clients or volunteers.

Information will be released to other individuals or non-BBBS organizations only with the client or volunteer's written consent.

Identifying information regarding clients and volunteers may be used in agency publications or promotional materials unless the clients or volunteers request otherwise.

For purposes of program evaluation, audit, or accreditation, and with the prior approval of the Board of Directors, certain outside bodies such as Big Brothers Big Sisters of America may have access to client and volunteer records.

Members of the Board of Directors or evaluators appointed by the Board have access to client files upon authorization of the Board of Directors.

Information will be provided to law enforcement authorities only upon the issuance of a valid and enforceable subpoena. However, general verbal information i.e., your affiliation with our organization and information that may be found, for instance, in BBBS publications may be given upon request of law enforcement authorities.

Information shall be provided to an agency's legal counsel in the event of litigation or potential litigation involving the agency.

State law mandates that suspected child abuse be reported to the appropriate authorities.

If an agency worker receives information indicating that a client or volunteer may be dangerous to himself or herself or to others, necessary steps may be taken to protect the appropriate party. This may include a medical referral or report to the local law enforcement authorities.

At the time a child or volunteer is considered as a match candidate, information is shared between the prospective match parties. The information about the volunteer may include such items as: age, sex, race, religion, interests, hobbies, marriage, family status, sexual orientation, living situation, etc. Information about the child may include such items as age, sex, race, religion, interests, hobbies, family situation, etc.

I have read and understand the above information provided to me regarding Big Brothers Big Sisters' confidentiality policy. I agree by the conditions set forth.

Volunteer Ground Rules

1) Bigs (volunteers) first and foremost are expected to be positive role models to their Littles (children with whom they are matched).

2) Bigs are expected to commit to the program for at least 1 school year and meet with their Littles for at one hour each week.

3) Bigs are required to maintain positive, productive contact with Match Support staff at least monthly for the first year and at least quarterly after the first year to ensure longer, stronger matches by discussing focus areas such as progress and safety.

4) Bigs should never transport a child off of school property for ANY reason. If you would like to attend a match activity with your Little, the Little must be transported to and from the event with their parent/ guardian. Transportation should NEVER be provided by a volunteer. Talk with your Match Support Specialist about anticipated participation in these activities.

5) BBBSTV staff members are mandatory reporters for the State of Alabama. Any suspected child abuse must be reported immediately. Bigs should contact the Department of Human Resources directly then immediately contact BBBSTV staff or contact BBBSTV staff immediately for assistance in reporting to DHR.

*Additional Volunteer Guidelines will be discussed during orientation.

I have read the above requirements, which define my responsibilities as a volunteer with Big Brothers Big Sisters. I agree to abide by them as long as I am in the program.

Social Media Guidelines

We realize that many of our volunteers are active on social media channels, such as Facebook, Twitter, Snapchat, Instagram, etc. As a volunteer for Big Brothers Big Sisters of the Tennessee Valley (BBBSTV), and ultimately a representative of our organization, we want you to keep these guidelines in mind when engaging on social media.

1. 1. Safety of Littles is our number one priority.

It is very important to keep child safety and confidentiality issues in mind when communicating on social media sites. Refrain from providing identifying information about your Little (child’s last name, parent’s name, child’s home address, school the child attends, where the parent works, etc). Also, never share the location of a Little on social media channels.

· For example, “My Little and I are having a great time at the zoo right now.” Specifying the location could jeopardize their safety.

· A better option would be to delay the message until after the activity. “I had a great time with my Little at the zoo today.”

1. 2. A parental release form is required for photo/videos.

In order to post pictures of your Little on any website or social media site, BBBSTV needs to obtain a consent form from the parent/ guardian. Please contact your MSS prior to the first time you post to obtain the release form to be signed by the parent/ guardian.

3. You are responsible for your actions and communications. Please exercise sound judgment when using social media channels.

Anything you post that could potentially tarnish the organization’s image or have a negative impact on our organization is your responsibility. When in doubt about whether or not a post is appropriate, consult with your Match Support Specialist prior to posting.

4. 4. Online privacy does not exist.

Do not assume that things you publish on a private personal profile cannot be accessed. No matter what settings are applied to your social networking sites, all it takes is for someone to copy and paste that information on to a public site. As a general rule of thumb, do not post content that you would not want to see in the newspaper.

5. Do not post anything that exemplifies questionable behavior as a role model for a child.

No alcohol or seemingly drunken behavior, cigarettes, nightclub activities, etc. should be referenced or shown in pictures, whether you are partaking or not. As a Big, you are a representative of BBBSTV and should reflect this through all of your social media messages and content, even if BBBSTV is not directly connected to the message. Also, be careful of questionable messaging on T-shirts, etc. in pictures. You are serving as a role model for your Little and for the community

6. We recommend that you DO NOT “friend” your Little through social media channels.

If you decide to, you must follow these guidelines:

a. Do not post pictures of your Little unless previously approved by written consent.

b. Do not post your Little’s full name, location, city, address, school or other personal information.

7. We strongly urge you to keep your profile set to private and closely monitor friend requests and followers on social media.

The people that you associate with on social media are a direct reflection of you. Please be aware that as a volunteer your interactions with others reflect on our organization.

8. Big Brothers Big Sisters has the right to monitor the social media of our Bigs.

If you are seen using social media inappropriately, your relationship with our organization could be terminated.

I have read and understand the social media guidelines set by Big Brothers Big Sisters of the Tennessee Valley. By signing this document, I am pledging to abide by these guidelines when using social media.

American Indian or Alaska Native	Asian Indian
Black or African American	Chamorro
Chinese	Filipino
Hispanic - Cuban	Hispanic - Mexican, Mexican American, Chicano
Hispanic - Other Latinx or Spanish Origin	Japanese
Korean	Middle Eastern or North African
Native Hawaiian	Other
Other Asian	Other Pacific Islander
Samoan	Vietnamese
White or Caucasian

Spanish	African Languages (Swahili, Bantu)
American Sign Language	Arabic
Asian: Other	Chinese
Creole	Dutch
Eastern European (Czech, Slovak)	French
German	Greek
Hebrew	Hmong
Indian (Hindi, Punjabi)	Italian
Japanese	Keres (West)
Korean	No Preference
Nordic	Persian
Portuguese	Russian
Turkish	Lao