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

Madison Park 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 Madison Park 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.

Español: https://bbbs.tfaforms.net/5005878 
Kreyòl: https://bbbs.tfaforms.net/5005892
Kabuverdianu: https://bbbs.tfaforms.net/5005899

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













Student Section

Following Section to be filled out by student


The Big Futures Mentoring Program purpose is to expose students to new pathways (college, entrepreneurship, military, the trades, and careers)

  • Prepares students to plan for the future
  • Connects students to opportunities like internships and scholarships
  • Fun events and FREE FOOD!
  • A community that sticks together
  • A mentor you can trust



Primary Guardian Address & Contact Info









(Optional Emergency Contact Information






(Optional) Contact Preferences




(Optional) Advice for Matching

Ex. Food allergies, IEP, etc


Ex. Skills, personality, background, etc






Contact Information