Big Futures Mentoring at Quincy High School: Youth Information and Consent Form

Quincy High School is excited to announce that it has partnered with Big Brothers Big Sisters of Eastern Massachusetts to provide one-on-one mentorship for your child through the Big Futures Mentoring program. We believe this is a tremendous opportunity for children at Quincy  High School and we hope you are as excited for your child to participate as we are. To learn more about how the program, please visit https://emassbigs.org/about/programs/big-futures/.


This form gives us the information we need to match your child with the right mentor for them. All information received is confidential and will only be shared with BBBSEM staff and your child’s mentor.  All information gathered as part of this process, including the form below, is the property of the BBBSEM agency.

Big Brothers Big Sisters of Eastern Massachusetts does not discriminate on the basis of race, ethnicity, sexual orientation, gender identity, religion or physical disability.

If you need to have this form in a different language other than the two provided please reach out to agordon@emassbigs.org

Português: Quincy_SignUp_PORT
Personal
Please provide all information as it would appear on legal documents (birth certificate, social security card, etc).  Thank you.













Primary Guardian Address & Contact Info









(Optional) Emergency contact information
In case we cannot reach you, please provide us with a local emergency contact:






(Optional) Contact preferences




(Optional) Advice for Matching

Ex. Food allergies, IEP, etc


Ex. Skills, personality, background, etc



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