High-School Big Application

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Thank you for your interest in becoming a Site-Based Big! Please complete the following application with a parent/guardian. Each Big applicant also needs two references, one from a family member and one from a teacher, staff, or employer; the forms will be emailed to those provided on this form. *BBBS respects the privacy of all applicants, all information will remain confidential unless it pertains to child safety.*
Applicant Information
























Parent/Guardian Information








Person(s) to be contacted in emergency situations if parent/guardian is not reachable





Reference Information

Please provide at least two references below including:
  • Your parent or guardian
  • Current or former teacher, counselor or coach you have known for at least one school year
Parent/Guardian Reference






Teacher/Counselor/Coach/Employer Reference







Youth Serving Reference Information
By providing this information you are giving BBBSMM Program Staff permission to contact the individuals listed to complete a reference check.






School-Based Mentoring Parental Consent
THIS SECTION MUST BE REVIEWED AND APPROVED BY A PARENT or LEGAL GUARDIAN of the APPLICANT!

By checking the box below, I give permission for my child, to participate in Big Brothers Big Sisters of Mid-Maine (BBBSMM) School-Based Mentoring one day per week after school. In doing so, I understand and agree to the following:
  • My child (Big) will meet with a local elementary or middle school student (Little) one day per week, during the school year, and communicate via TheApp during the summer months or other extended school breaks: meeting requirements for a 12-month minimum commitment.
  • My child (Big) will communicate with BBBS staff (in person, via phone, text or email) at least once a month. 
  • School personnel may share information regarding my child with BBBSMM for the purpose of determining a suitable mentee and addressing child safety concerns as well as reporting on school attendance and overall performance.
  • All applicant information in regards to my child will be kept strictly confidential.
  • I am responsible for picking-up my child, or arranging transportation for my child, at the designated end time of each match meeting.
  • BBBSMM does not guarantee my child will be matched and has discretion in creating and/or closing a match in regards to child safety and the best interests of all parties involved.
  • I understand contact between Bigs and Littles outside of school mentoring activities is not permitted.
Emergency Medical Consent
Media Release
Big Brothers Big Sisters of Mid-Maine creates media (brochures, press releases, annual appeal letters, BBBSMM website, TV and radio spots, etc.) to highlight match successes and recruit volunteers. I understand my child's interaction with his/her match may be photographed/taped and possibly used for these agency purposes only.
TheApp
Mentor Agreement
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Contact Information