Youth Inquiry (Revised 2024)

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Page 1

Welcome!

We are currently enrolling:

All youth ages 8-13 in Hampton Roads
Girls only ages 6-13 in the Virginia Peninsula

Enrollment for all youth in the Greater Richmond and Tri-Cities regions opens annually in August.

Youth Gender

Personal Pronouns

How does the youth identify?

What pronouns does the youth use?

Which community are you enrolling your youth in?

Thank you for your interest in enrolling your child in our program.

Unfortunately, we are not accepting new Little applications in your area at this time, as we must prioritize matching youth already waiting for a Big.

In the meantime, you can visit the Mentoring Connector to find other programs in your area: https://www.mentoring.org/what-we-do/mentoring-connector/

Waitlist Notice

Thank you for your interest in a mentor! We are excited to learn more about you and your child. Please keep in mind that completing this form will add your child to our waiting list. It will likely take some time to find an eligible mentor who is well-suited for your child. We believe our staff is able to make high-quality, long-lasting matches through our intentional matching process, and thank you in advance for your patience.

Please submit this form for each child you would like to enroll!

BBBS Information

Community Based Mentoring: Each volunteer (Big) is matched with one child (Little) between the ages of 6 and 13. On a schedule that works for the child and the Big, they get to spend quality time with each other sharing local culture, exploring new educational opportunities, developing new skills and hobbies.

Community Based Littles are…

Between 6-13 years old (or 8-13 in Hampton Roads region)
On outings 2-4 times per month, on your own schedule, for one year
Picked up and dropped off by their Big from their home

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.

Page 2

Youth Information

First Name

Last Name

Application Name

Concatenated from First + Last

Preferred Name

Birthdate

School

Graduation Year from High School

This is the year the youth will graduate.

Does the child receive free or reduced lunch?

YesNo

School Account ID

Race/Ethnicity

Parent/Guardian Information

Parent/Guardian First Name

Parent/Guardian Last Name

You (the parent/guardian) are this child's:

Marital status of the parent/guardian:

Mobile Phone

Personal Email

Alternate Email

Geographic Information

Street Address

City

State

Zip Code

County:

How did you hear about Big Brothers Big Sisters?

Do you have any plans to move in the next 6-12 months?

YesNo

Tell us about your potential move. When? Where?

Family Information

Are other children in your family in our program?

YesNo

Names of children involved with BBBS:

Does anyone else live in the home (besides you and the child you are enrolling)?

YesNo

Who else lives in the home?

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