LogoYouth Referral Form  

| Resume a previously saved form
Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

Instructions

This form is to be completed by the school/site staff/worker/counselor (not the parent/guardian). Please complete the entire form.

Thank you for taking the time to refer a child to Big Brothers Big Sisters of Central MN. Our program serves children who reside in Stearns, Benton, Morrison or Sherburne counties, and the upper tier of Wright county. You may refer a child to any of our three programs:

Community-based Program -  Community-based Mentoring is a one-to-one mentoring program where a mentor meets with the child out in the community two to four times a month (on average 2 to 5 hours per outing).   Children in this program must be between the ages of 7 and 16.

School-based Program - School-based Mentoring is a one-to-one mentoring program where a mentor meets with a child in the child’s school, 2 to 4 times per month for one year (meeting in person while school is in session and maintaining contact over the summer by phone, mail or email).  Children in this program must be in grades K-8th grade. We have School-Based programs in following districts: Foley, Holdingford, Pierz, St. Cloud, Sartell St. Stephen, and Sauk Rapids-Rice.

 

Sports Buddies Program – Sports Buddies is a program where one-to-one mentoring relationships and friendships are formed while engaging in athletics. Activities are planned and facilitated by a BBBS staff member and include both participating in and watching sports. Matches will attend 1-2 events per month on evenings and weekends. Most events run between two and four hours. Littles must be 8 and older to participate.

Inclusion Statement

At Big Brothers Big Sisters of Central MN, diversity, equity, and inclusion (DEI) is an integral part of our values and mission.  We recognize, affirm, and celebrate the diverse backgrounds, lives, and experiences of our stakeholders, including youth, families, board members, donors, volunteers, and staff.  We ensure the opportunity for voices and perspectives to be heard and honored.  In the community, we foster an environment where people can be their best selves.


We affirm that every person [regardless of ability, age, cultural background, ethnicity, faith, gender, gender identity, gender expression, income, national origin, race or sexual orientation, marital or veteran status] has the opportunity to reach their full potential.  We strive to realize the full potential that is within all of us by ensuring that voices and perspectives are heard and honored.

Hidden Fields

To look up the owner's email for notifications

For notifications



Child's Information





Enter a date in the following format: mm/dd/yyyy



Press CTRL while choosing to select multiple


Start typing to find your child's school



This is the year the youth will graduate.
Use this Graduation Year Calculator for Assistance.
Parent/Guardian Information





Family Information






Criteria 
Big Brothers Big Sisters of Central MN seeks to serve children who are most in need of our services.  Children are eligible for our program if they meet the age requirement (5-14 for School Based, 7-17 for Community Based, 8-16 for Sports Buddies) and have one or more of the following traits.









Referred By 






Your Signature