BBBS Volunteer Application

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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. 

Important Message
**Please be sure to check your primary AND junk/ spam email folders for any follow-up material from BBBSBC, FormAssembly, or MatchForce after completing each step of the enrollment process.**

Volunteer Age Requirement

Volunteer Age Requirement
Unfortunately, we are unable to continue with your enrollment as a volunteer. Our program requires volunteers be over the age of 18 for our Community Based Program. We hope you will reconsider applying in the future when you have reached our required age. 

If you have any questions, please contact our Program Director, Christina Roebuck,  at 215.343.8260 x105 or email: CrRoebuck@bbbsbc.org.


Thank you! 
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References and Background Check

Previous Experience










Volunteer Experience











Please provide at least three references below including:
  • Your spouse or domestic partner OR a family member if you do not have a spouse, partner, or significant other.
  • Current or former employee or co-worker you have known for at least one year or someone from your school if you are a student
  • A friend or neighbor you have known for at least two years
Spousal/Familial Reference







Professional Reference







Minimum 1 year
Personal Reference







Minimum 2 years
I consent to and understand that:
  1. The references and youth-serving organization(s) I listed may be contacted by mail, telephone, email, or in person;
  2. The information I provided may be used to conduct a background check, to include a search of public domain records, driving records check, juvenile and adult criminal history check (see attached authorization), military records, and other records where required by local, state, or federal law for volunteers working with youth;
  3. I am in no way obligated to perform any volunteer services;
  4. The BBBS agency is not obligated to match me with a youth and may deny my application or close my match at any time, and to protect all participants’ confidentiality, BBBS is not required to disclose reasons for doing so; 
  5. Other BBBS agencies and youth organizations where I have worked or volunteered may be contacted as references;
  6. As part of the enrollment processes, I will be required to provide additional personal information, including completion of an in-person interview;
  7. I understand that the information I provide in the enrollment process will be kept confidential, unless disclosure is required by law.  
  8. I understand that detailed accounts of child abuse or neglect, past or present, will be reported to proper authorities;
  9. I understand that certain relevant information about me will be discussed with the parent/guardian of a child who is a prospective match (this might include demographic information, information relevant to parent/child preferences, and any information relevant to a child’s safety or well-being);  
  10. It is my responsibility to update the agency if any of the information I provide on this application, in my interview, or any other information provided during the enrollment process changes (i.e. address, phone number, auto-insurance, new criminal charges, etc.)
  11. I agree to complete questionnaires throughout my time in the program to evaluate and improve program services;
  12. I agree to timely communication and follow-up with all agency staff as required by the agency.

Pre-Interview Questionnaire

Prior to your in-person interview, please answer the questions below. The information you provide will also help us make a better match for you and assure we can support you during your involvement with our program. Please note that you will have an opportunity to discuss these questions and your responses more thoroughly during your in-person interview.  





Agency Weapons Policy

Insert Firearms and Weapons Guidelines








Please provide the name, age, and relationship to you for anyone else residing in your home.


Release of Information Authorization for Background Check

CONSENT / RELEASE OF INFORMATION AUTHORIZATION FORM FOR THE PENNSYLVANIA CHILD ABUSE HISTORY CLEARANCE 

I, ______________________________   (applicant) hereby authorize the Department of Public Welfare, ChildLine to release my Pennsylvania Child Abuse History Clearance information directly to:  Big Brothers Big Sisters of Bucks County. 
 
I understand that this information is confidential in nature pursuant to S6340 (relating to information in confidential reports) of the Child Protective Services Law (CPSL) (23Pa.C.S. Chapter 63) and will not otherwise be released by Big Brothers Big Sisters of Bucks County without my express authorization or pursuant to authorization by Title 55 of the Pennsylvania 
Code. I understand that the aforementioned information will not be released directly to me ______________________________ (applicant) as stated on the Pennsylvania Child Abuse History Clearance application. 
 
By consenting down below, I also...

Understand that I will not receive a copy of my Pennsylvania Child Abuse History Clearance directly from ChildLine; however, I may request a copy of my Pennsylvania Child Abuse History Clearance from Big Brothers Big Sisters of Bucks County upon written request. 
 
 Have read this Consent/Release of Information Authorization form and fully understand and agree to its content. I further understand and agree to all information and ramifications of the Pennsylvania Child Abuse History Clearance application as it otherwise relates to this consent. 

Confidentiality and Digital Platform Policies

BBBSBC Confidentiality Policy


Big Brothers Big Sisters of Bucks County, Inc. respects the confidentiality of Youth and 

Volunteer records.  The records are not open for review by anyone including the Youth and 

Volunteer.  Exceptions will be made under the following situations: 


- Youth, parent/guardian, or volunteer signs a "Consent to Release" form. 


- An outside group such as Big Brothers Big Sisters of America and/or a designated 

member of the Board of Big Brothers Big Sisters of Bucks County obtains 

permission from the Chief Executive Officer or the Board of Directors for the 

purposes of program evaluation. 


- The agency is presented a subpoena by the courts. 


- Consultation is required with the agency's legal advisor. 


- There is a suspicion of child abuse, which requires the agency to make a report to 

the appropriate authorities. 

 

- A Youth or Volunteer threatens harm to himself or others, which requires the 

agency to take appropriate action. 

 

Agency professional staff will verbally disclose information about you to a potential match, and 

you will also receive information about a potential match partner.  The information you receive 

about a potential match partner is confidential, and it should not discussed with anyone other 

than your assigned case manager. 

 

I have read, understand, and received a copy of the above policy on confidentiality and agree 

to program participation under the conditions it sets forth. 



Social Media Guidelines


I give my permission for Big Brothers Big Sisters of Bucks County and its affiliates/associates to 

use my photograph, taken during agency events/activities, for promotional purposes.    


 I release Big Brothers Big Sisters of Bucks County, Inc., their affiliates/associates, nominees 

and designees from any liability otherwise owed to me in connection with personal or proprietary right I may have as a result of the sale, reproduction, or use of photographs as described above. 


This consent may be terminated at any time by me in writing. 

Virtual Platform


Media Consent and Release

Media Consent and Release


I consent to the use and display of my image, likeness, appearance, basic biographical

information, audio/video recordings, writings, artwork, and the like, in original form or in

modified form, in whole or in part, in, on, or in connection with merchandise, advertising,

publicity, marketing, fundraising, and the like, in printed or electronic media, of any type,

throughout the world at any time by Big Brothers Big Sisters of America and Big Brothers Big

Sisters of Bucks County.

 

In consideration of the mutual promises made herein, and for other good and valuable

consideration, the receipt and sufficiency of which I hereby acknowledge, I hereby grant Big

Brothers Big Sisters of Bucks County the right to use the Released Material as in media now

existing or hereafter created and in all variations and forms including, but not limited to,

internal or external publications or productions, informational or recruitment materials,

marketing materials, fundraising materials, televised photography and/or recordings,

advertisements, and/or online and social media sites.

Media Release Acknowledgement 

Child Safety Guidelines and Ground Rules for Volunteers                                                                      

Child Safety Guidelines and Ground Rules for Volunteers

Maintain contact with Big Brothers Big Sisters of Bucks County (BBBSBC): 
- Maintain contact with BBBSBC on a monthly basis.  Promptly return any calls from the Match 
Support Specialist. 
- Stay in touch with your Match Support Specialist (monthly during the first year of the match and  quarterly thereafter) to advise them of your activities, the development of the match relationship between Big and Little, to receive coaching and feedback, and to relay any questions or concerns you may have. 
- Complete annual surveys conducted by your Match Support Specialist to provide BBBSBC 
feedback on your match relationship and child’s development. 
- Call BBBSBC at 215-343-8260 immediately with any child safety concerns/suspected abuse 
or to report an injury or accident. 
 
Roles and Boundaries: 

Parents/Guardians: 

- Parents/guardians should be aware and consent to all activities to which their child will 
participate. 
- Parents and/or guardians are ultimately responsible for the well being of their child.  Therefore, if the child has some conflict with school, law, etc., the Big should not intercede on behalf of the 
parent/guardian. 
- Parent will communicate with the Big to arrange times for the Little and Big to meet. 
- Regularly ask the Little questions about the match relationship, to ensure that the child feels safe comfortable, and happy.  (See Child Safety Guide for suggested questions.) 
- Parents should never ask a Big to do any favors not related to the match: babysitting, running 
errands, providing transportation not related to the match activity. 
- Keep personal information regarding your Big confidential and discuss only with BBBSBC. 

Bigs: 
- A Big’s relationship with a parent should be centered on the Little.  Bigs and parents should not 
get together on their own, and romantic relationships between Bigs and parents are prohibited. 
- Never come between the parent/guardian and child; respect parental role and authority. 
- When communicating any concerns about your Little, please do so privately with the 
parent/guardian and your Match Support Specialist. 
- Keep personal information regarding your Little confidential and discuss only with BBBSBC. 
 
Personal boundaries: 
- Affection is best expressed through positive /affirming comments. 
- Respect your Little’s personal space and privacy. 
- Physical affection may be expressed using a handshake, high five, pat on back or hug. 
- Wrestling, tickling, or children sitting on laps is prohibited. 
- Never sleep or nap with your Little in the same bed, sleeping bag, or sofa. 
- Contact your Match Support Specialist if there are any concerns about a Little’s boundaries or 
expression of affection. 
 
Involving family members/friends on match activities: 
- Remember, match relationships should be primarily one-to-one between Big and Little

Parents should not ask the volunteer to include any other children on match activities. Please: 
- Be aware that Bigs assume total responsibility and liability for any other person who attends a 
- Secure permission from Littles’ parent /guardian before inviting a friend or relative on a match 
- Others (ex:  significant others, friends, own children, Little’s siblings and friends) should only be 
included in match activities for special occasions and circumstances.
- Take into consideration the preference and comfort of your Little before including anyone 
- Be respectful of the volunteer’s time and commitment to your child. 

If inviting another minor child, Bigs must also get their parent’s permission before the 
activity takes place. Match activity who is not enrolled in BBBSBC and you are responsible for such third party’s behavior, supervision, and safety during the Match activity.

 
Supervision and transportation of child/youth: 
- Bigs are responsible for the supervision of your Little and at no time should the child be left 
unsupervised or left with someone else during a match activity. 
- Do not allow others to transport your Little (friends, family, roommate, partner). 
- Do not talk or text on a cell phone while transporting your Little in a vehicle. 
- Big must, maintain a working phone number where your Little’s parents or BBBSBC can 
contact you while on an outing with your Little and inform parent/guardian on where Big and 
Little plan to go. 
- Parent must, maintain a working phone number where your child’s Big can reach you, or 
provide a telephone number of a relative or neighbor, where you can be reached. 
- Big must create a plan with your Little that you will both follow if you get separated while on an 
outing. 
- Follow Pennsylvania state guidelines, which state that children ages 4-8, are required to be in a 
booster seat unless the child is over 80 lbs or at least 4’9” tall. It is also recommended that 
children under 13 ride in the back seat. Consult with a parent/guardian regarding their preference. 
- Drivers and passengers are required to wear a seatbelt wherever they sit in the vehicle. 

When returning child home after a match activity: 
- Ensure that your Little is safely in their home before leaving. 
- Don’t drop child off unattended unless previous arrangement has been made with the 
parent/guardian. 
- Check in with the parent/guardian letting them know how the activity went. 
 

If the child gets sick: 
- Parent/guardian must provide the Big and BBBSBC have the most up to date, relevant medical information;  including allergies, medical conditions, and insurance information in case of an accident. 
- Big may never give medication unless given written permission from the parent/guardian. 
- Big must always carry your Little’s current medical form and contact information and the 
BBBSBC phone number. 
- If Little or Big are sick on the day of a scheduled visit, please let each other know in advance and reschedule the activity for another day. 
 
 
General Safety: 

Matches are not permitted to have match activities in the Bigs home for the first three (3) months 
-Visits should not exceed once a week unless discussed with your Match Support Specialist. 
- Ensure that your Little wears a lifejacket when on a boat, dock and anywhere around the water. 
- BBBSBC insurance policy does not cover aircraft, motorcycle/all terrain vehicles, and firework 
- Escort the child to any public restroom to ensure safety. 
- Appropriate swimwear and changing facilities are required for swimming. 
- Provide separate/private areas for your Little to change or bathe. 
- Do not carry a firearm or have an unsecured firearm while in the presence of your Little. 
- Obtain Parent/Guardian permission before engaging in any activity dealing with a firearm or any 
- Children under 12 are required by law to wear an appropriate helmet while riding bike.  It is 
of their match. After their 3 month mark, activities at the Bigs home are up to the discretion of the Little and Parent/Guardian. 
strongly recommended that your Little wear a helmet while skateboarding, roller-skating, 
rollerblading, skiing, or snowboarding. 
potentially dangerous weapon. Discuss the proposed activity with your Match Support Specialist. 
accidents. 
 
Movies, video games, media, Internet: 
- Follow content ratings for all media forms (PG, PG-13, TV-14, M etc.) 
- Viewing content with your Little that contains explicit sex, graphic violence, or 
pornography is strictly prohibited, and grounds for match closure. 
- Obtain Parent/Guardian permission before connecting with your Little through social networking 
site. 
- BBBSBC strongly recommends Bigs, Littles and family members to not connect on social media. 
- Obtain Parent/Guardian permission before posting pictures of your Little on the Internet.
- Inform your Match Support Specialist of websites where you have posted pictures of your Little. 
 
Gift giving, donations, work for pay: 
- Small gifts are permissible for birthdays, holidays, special events, or recognition of personal 
achievement. 
- Gifts should never be purchased and kept at the volunteer’s home without the knowledge and 
permission of the parent/guardian and Match Support Specialist. 
- Large donations of furniture, clothing, money, computers, bikes or any professional services to 
Little/family are inappropriate and should be discussed with your Match Support Specialist. 
- Providing opportunities for your Little to earn money should be discussed with the 
parent/guardian and your Match Support Specialist. 
- The Big has no financial responsibility for the support of the child and/or the child’s family. 
 
Discipline/setting limits: 
- Physical discipline is never allowed. 
- State expectations for behavior, and set appropriate boundaries. 
- Verbally address behavior concerns, clarify what needs to change or happen. 
- If your Little does not respond, take him/her home and inform parent/guardian. 
- The Big is not a disciplinarian on behalf of the parent or guardian. The parent may not punish the child by refusing to let the child see his/her Big. However, we encourage the parent to enlist the support of the Big in addressing the child’s poor behavior. 
 
Use of alcohol, drugs, tobacco: 
- Do not consume alcohol or any illegal drug prior to or during a match activity. Do not 
engage in any illegal activity while in the presence of your Little. Do not purchase or use 
any tobacco products while in the presence of your Little. 

BBBSBC policy prohibits the use of any illegal drug and/or alcohol by either adult volunteers or 
boys/girls in the presence of one another. A violation of this policy will result in termination from 
the program. 
 
Personal stressors / life changes: 
- If at any time during your match you are experiencing significant life stressors which may 
interfere with your match, please discuss these circumstances with your Match Support Specialist. 
- Update your Match Support Specialist of changes in jobs, contact information, address, telephone 
number, connectivity, e-mail address, availability, etc. 
- Update Match Support Specialist of changes in Little’s family, significant other, living situation, 
health issues, safety issues, availability, inappropriate requests, etc. 

Application Acknowledgement

I understand that this is an application for a volunteer opportunity and is not a promise or commitment by Big Brothers Big Sisters.

I certify that all information I have provided or will provide to Big Brothers Big Sisters, including this application, is true, accurate, and complete to the best of my knowledge. I certify that I have and will answer all questions to the best of my ability and that I have not and will not withhold any information that would affect my application for a volunteer position. I understand that information contained in my application will be verified by Big Brothers Big Sisters. I understand that misrepresentations or omissions may be cause for my immediate rejection as an applicant or my termination as a volunteer.

At any time while involved with the Big Brothers Big Sisters program, I agree to immediately inform my Big Brothers Big Sisters contact person of any and all infractions, violations, charges, and convictions related to any civil, domestic, or criminal matters.  I understand that BBBS staff needs to be fully informed to provide the best guidance or support possible.  

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