DINO Chaperone/Group Mentoring and Non-Mentoring Volunteer Application

Hidden Fields



Military Experience

Demographic information is collected for grant requirements that allow us to pay for the work our agency does. We are an inclusive organization and celebrate diversity!

Emergency Contact Information


Personal Interests and Health

BBBS & Youth Serving Experience

Media Release

Sharing stories and celebrating your success is an important part of our mission!

Background Checks

Washington State Criminal History Check

Washington State Law requires that all volunteers who will have regularly scheduled unsupervised access to children under sixteen years, or developmentally disabled persons, complete and sign this disclosure statement. For the safety of our children, Big Brothers Big Sisters of Island County is requiring ALL VOLUNTEERS to complete and sign this form, which allows BBBSIC to conduct a Washington State Patrol background check. (An inquiry to the Washington State Patrol and/or state and federal law enforcement agency will be made for 

selected candidate.)

(PAGE 5 of this application is a Summary of Your Rights)


Big Brothers Big Sisters of Island County may obtain information about you from a third party consumer reporting agency for employment or volunteer assignment purposes. Thus, you may be the subject of a “consumer report” which may include information about your character, general reputation, personal characteristics, and/or mode of living. These reports may contain information regarding your criminal history, social security verification, motor vehicle records (“driving records”), verification of your education or employment history, or other background checks.

The investigations will be conducted by Sterling Infosystems Inc. 4511 Rockside Road, 4th Floor, Independence, OH 44131. 1.866.338.6739 www.sterlingcheck.com.

Washington State residents and applicants only:  You also have the right to request from the consumer reporting agency a written summary of your rights and remedies under the Washington Fair Credit Reporting Act.  


I acknowledge receipt of the separate documents entitled DISCLOSURE REGARDING BACKGROUND INVESTIGATION, A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT and OTHER STATE LAW NOTICES  and certify that I have read and understand those documents. I hereby authorize the obtaining of “consumer reports” and/or “investigative consumer reports” by Big Brothers Big Sisters of Island County at any time after receipt of this authorization and throughout my volunteer assignment, if applicable. To this end, I hereby authorize, without reservation, any law enforcement agency, administrator, state or federal agency, institution, school or university (public or private), information service bureau, employer, or insurance company to furnish any and all background information requested by Sterling Infosystems Inc. 4511 Rockside Road, 4th Floor, Independence, OH 44131. 1.866.338.6739 www.sterlingcheck.com and/or Big Brothers Big Sisters of Island County . I agree that a facsimile (“fax”), electronic or photographic copy of this Authorization shall be as valid as the original.
I acknowledge and authorize a background investigation as stated above.

Photo Idenitification

Alternative ID

Personal History

Volunteer Consent

Updated Background Checks
I understand that child safety is the first and foremost concern of BBBS of Island County. I agree to inform Big Brothers Big Sisters staff of any involvement that I have with law enforcement for the duration of the time that I am volunteering as a chaperone or as a non-mentoring volunteer.  I understand that Big Brothers Big Sisters will run a background check on me every 3 years (minimum) that I am volunteering.  Every 3 years I will respond to staff’s requests for background check authorization signatures and understand that failure to do so will result in an end to my volunteering with the agency.  Staff will use professional judgment on whether any accusations or charges warrant an end to volunteering or chaperoning.

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;

4)  BBBSIC is not obligated to accept me as a volunteer or chaperone, may deny my application or cease my volunteering at any time, and to protect all participants’ confidentiality, BBBSIC 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;

7) I understand that the information I provide in the screening process will be kept confidential, unless disclosure is required by law. I understand that detailed accounts of child abuse or neglect, past or present, will be reported to proper authorities;

8) It is my responsibility to update the agency if any of the information I provide on this application changes (i.e. address, phone number, new criminal charges, moving violations, etc.).

9)  I agree to complete questionnaires throughout my time in the program to evaluate and improve program services;

10) I agree to timely communication and follow-up with all agency staff as required by the agency.


I understand that this is an application for an unpaid 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. 

Type Name



The federal Fair Credit Reporting Act (FCRA) is designed to promote accuracy, fairness, and privacy of information in the files of every “consumer reporting agency” (CRA). Most CRAs are credit bureaus that gather and sell information about you — such as if you pay your bills on time or have filed bankruptcy — to creditors, employers, landlords, and other businesses. You can find the complete text of the FCRA, 15 U.S.C. §§ 1681-1681u, at the Federal Trade Commission’s web site (http://www.ftc.gov). The FCRA gives you specific rights, as outlined below. You may have additional rights under state law. You may contact a state or local consumer protection agency or a state attorney general to learn those rights.


·       You must be told if information in your file has been used against you. Anyone who uses information from a CRA to take action against you — such as denying an application for credit, insurance, or employment — must tell you, and give you the name, address, and phone number of the CRA that provided the consumer report.


·       You can find out what is in your file. At your request, a CRA must give you the information in your file, and a list of everyone who has requested it recently. There is no charge for the report if a person has taken action against you because of information supplied by the CRA, if you request the report within 60 days of receiving notice of the action. You also are entitled to one free report every twelve months upon request if you certify that (1) you are unemployed and plan to seek employment within 60 days, (2) you are on welfare, or (3) your report is inaccurate due to fraud. Otherwise, a CRA may charge you up to eight dollars.


·       You can dispute inaccurate information with the CRA. If you tell a CRA that your file contains inaccurate information, the CRA must investigate the items (usually within 30 days) by presenting to its information source all relevant evidence you submit, unless your dispute is frivolous. The source must review your evidence and report its findings to the CRA. (The source also must advise national CRAs — to which it has provided the data — of any error.) The CRA must give you a written report of the investigation and a copy of your report if the investigation results in any change. If the CRA’s investigation does not resolve the dispute, you may add a brief statement to your file. The CRA must normally include a summary of your statement in future reports. If an item is deleted or a dispute statement is filed, you may ask that anyone who has recently received your report be notified of the change.


·       Inaccurate information must be corrected or deleted. A CRA must remove or correct inaccurate or unverified information from its files, usually within 30 days after you dispute it. However, the CRA is not required to remove accurate data from your file unless it is outdated (as described below) or cannot be verified. If your dispute results in any change to your report, the CRA cannot reinsert into your file a disputed item unless the information source verifies its accuracy and completeness. In addition, the CRA must give you a written notice telling you it has reinserted the item. The notice must include the name, address and phone number of the information source.


·       You can dispute inaccurate items with the source of the information. If you tell anyone — such as a creditor who reports to a CRA — that you dispute an item, they may not then report the information to a CRA without including a notice of your dispute. In addition, once you’ve notified the source of the error in writing, it may not continue to report the information if it is, in fact, an error.


·       Outdated information may not be reported. In most cases, a CRA may not report negative information that is more than seven years old; ten years for bankruptcies.


·       Access to your file is limited. A CRA may provide information about you only to people with a need recognized by the FCRA — usually to consider an application with a creditor, insurer, employer, landlord, or other business.


·       Your consent is required for reports that are provided to employers, or reports that contain medical information. A CRA may not give out information about you to your employer, or prospective employer, without your written consent. A CRA may not report medical information about you to creditors, insurers, or employers without your permission.


·       You may choose to exclude your name from CRA lists for unsolicited credit and insurance offers. Creditors and insurers may use file information as the basis for sending you unsolicited offers of credit or insurance. Such offers must include a toll-free phone number for you to call if you want your name and address removed from future lists. If you call, you must be kept off the lists for two years. If you request, complete, and return the CRA form provided for this purpose, you must be taken off the lists indefinitely.


·       You may seek damages from violators. If a CRA, a user or (in some cases) a provider of CRA data, violates the FCRA, you may sue them in state