BBBS of Shelby and Darke County Volunteer Application

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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. 

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Contact Information



























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References and Background Check

Previous Experience










Volunteer Experience











Please provide at least three references below including:
  • Your spouse or domestic partner OR a family member if you do not have a spouse, partner, or significant other.
  • Current or former employee or co-worker you have known for at least one year or someone from your school if you are a student
  • A friend or neighbor you have known for at least two years
Spousal/Familial Reference







Professional Reference







Minimum 1 year
Personal Reference







Minimum 2 years
I consent to and understand that:
  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;
  3. I am in no way obligated to perform any volunteer services;
  4. The BBBS agency is not obligated to match me with a youth and may deny my application or close my match at any time, and to protect all participants’ confidentiality, BBBS 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;
  6. As part of the enrollment processes, I will be required to provide additional personal information, including completion of an in-person interview;
  7. I understand that the information I provide in the enrollment process will be kept confidential, unless disclosure is required by law.  
  8. I understand that detailed accounts of child abuse or neglect, past or present, will be reported to proper authorities;
  9. I understand that certain relevant information about me will be discussed with the parent/guardian of a child who is a prospective match (this might include demographic information, information relevant to parent/child preferences, and any information relevant to a child’s safety or well-being);  
  10. It is my responsibility to update the agency if any of the information I provide on this application, in my interview, or any other information provided during the enrollment process changes (i.e. address, phone number, auto-insurance, new criminal charges, etc.)
  11. I agree to complete questionnaires throughout my time in the program to evaluate and improve program services;
  12. I agree to timely communication and follow-up with all agency staff as required by the agency.

Pre-Interview Questionnaire

Prior to your in-person interview, please answer the questions below. The information you provide will also help us make a better match for you and assure we can support you during your involvement with our program. Please note that you will have an opportunity to discuss these questions and your responses more thoroughly during your in-person interview.  





Agency Weapons Policy

Disclosure: Volunteers must disclose any firearms, weapons, or ammunition at enrollment, during the match, and at re-assessments. Disclosure to the Little's family may occur if necessary.


Compliance: Volunteers must ensure all firearms and weapons are licensed, permitted, and comply with state and federal laws.


Safety: Weapons and ammunition must be inaccessible to the Little, except during approved activities (e.g. hunter safety courses), which must be documented.


CCW License Holders: Volunteers with a CCW license should not carry weapons during outings with their Little, except for Bigs with Badges in uniform.






Please provide the name, age, and relationship to you for anyone else residing in your home.


Release of Information Authorization for Background Check

Children’s safety is our #1 priority. We focus on the child’s safety and well-being throughout the match.

Every Volunteer is required to complete a standard Background Check prior to be matched with a Little. These are completed through DATASOURCE, a trusted entity of Big Brothers Big Sisters of Shelby and Darke County.
By checking the box below, you are consenting to BBBS of Shelby and Darke County staff to run and read these reports completed with Datasource. You understand and agree that completing a Background check does not guarantee approval from BBBS of Shelby and Darke County.

I hereby authorize Big Brothers Big Sisters of Shelby and Darke County, and/or its agents to make an independent investigation of my background, criminal, police or children's services records, including those maintained by both public and private organizations and all public records for the purpose of confirming the information contained on my application and/or obtaining other information which may be material to my qualifications to be a volunteer or employee. If selected as a volunteer, or hired as a employee or contracted agent, this authorization shall remain on file and shall serve as ongoing authorization for Big Brothers Big Sisters of Shelby and Darke County to procure such reports at any time during my employment, contract, or volunteer period. I authorize, without reservation, any person, business or agency contacted by the consumer reporting agency to furnish the above - mentioned information.

I release Big Brothers Big Sisters and/or its agents and any person or entity, which provided information pursuant to this authorization, from any and all liabilities, claims or lawsuits in regards to the information obtained from any and all of the above referenced sources used.

I further understand that this information is required for identification and screening purposes, and in no manner used as qualification for employment or volunteering. Big Brothers Big Sisters is an Equal Opportunity Employer, and does not discriminate on the basis of Sex, Race, Religion, Age, Handicap, or National Origin.

I understand that I have the right to make a request to the consumer reporting agency. Datasource, Inc. ('Agency"), 1200 South Outer Road, Blue Springs, MO 64015, telephone number (877)577-3832, upon proper identification, to obtain copies of any reports furnished to Big Brothers Bg Sisters of Shelby and Darke County by the Agency and to request the nature and substance of all information in its files on me at the time of my request, including the source of informatrion, and the Agency, on Big Brothers Big Sisters of Shelby and Darke County's behalf, will provide a complete and accurate disclosure of the nature and scope of the investigation covered by any investigative consumer report(s). I hereby consent to Big Brothers Big Sisters obtaining information from the Agency. I understand that I can dispute, at any time, any information that is inaccurate in any type of report with the Agency. I may view the Agency's privacy policy at their website: www.datasourcecorp.com.

Confidentiality and Digital Platform Policies

The purpose of this Confidentiality Policy is to protect the personal and sensitive information of all individuals involved in the Big Brothers Big Sisters (BBBS) program, including but not limited to children (Littles), volunteers (Bigs), parents/guardians, and staff.


BBBS is committed to maintaining the confidentiality of all information obtained during the enrollment, matching, and match support processes. This includes verbal, written, and electronic communications. All BBBS staff, volunteers, and Board members are expected to uphold this policy.


Confidential information will only be accessible to:

  • BBBS staff with a legitimate need to know

  • Authorized personnel involved in match support or supervision

  • External parties only with signed consent or as required by law

While BBBS strives to maintain confidentiality, there are certain legal and ethical circumstances under which information must be disclosed:

  • Suspected child abuse or neglect

  • Threats of harm to self or others

  • Court orders or subpoenas

  • Situations required by law or mandated reporting obligations

All records are securely stored and protected against unauthorized access. Electronic records are maintained in secure databases with password protection, and physical documents are stored in locked file cabinets. Access is limited to approved staff only. Staff will use secure methods when sharing confidential information. Email, phone, or online communications must follow organizational privacy practices (e.g., use of secure servers or encrypted messages when necessary). 

To promote safety, privacy and confidentiality of all Agency participants, children and their families, volunteers, Board members, and Agency staff must follow the below guidelines:

-Volunteers, Board members, and Agency Staff have access to agency announcements, match opportunities, and updates through mailings, newsletters, and emails, which are not to be shared to the general public or through social network sites.

- Volunteer Bigs must refrain from any communication with their Little through social networking until they receive guardian approval.

- Volunteer Bigs who communicate with their Littles through social networking must maintain their relationship as one of a mentor.

- Pictures of Littles must never be posted online without consent of the Littles guardians.

- Pictures of Littles, volunteers and their families must never be 'tagged',  or use any identifying information or linking their personal pages.
Virtual Platform


Media Consent and Release

I irrevocably consent to any and all uses and displays of my name, image, likeness, appearance, basic biographical information, audio/video recordings, writings, artwork, and the like, in original form or in modified form, in whole or in part, in, on, or in connection with merchandise, advertising, publicity, marketing, fundraising, and the like, in printed or electronic media, of any type, throughout the world at any time by Big Brothers Big Sisters of America and [BBBSA affiliate] in their sole discretion, and by any of their affiliates, successors, partners, sponsors, donors, any entities or persons with whom they conduct any public relations, marketing, or fund raising of any type, and any other authorized third parties, without further consent from me, without any royalty, payment, or other compensation to me, and with the release and waiver of any claims, actions, damages, losses, costs, expenses and liability of any kind arising from any such use (the “Released Material”).
In consideration of the mutual promises made herein, and for other good and valuable consideration, the receipt and sufficiency of which I hereby acknowledge, I hereby grant to BBBSA and its affiliates the right to use the Released Material as BBBSA and/or its affiliates may desire, in all media now existing or hereafter created and in all variations and forms including, but not limited to, internal or external publications or productions, informational or recruitment materials, marketing materials, fundraising materials, televised photography and/or recordings, advertisements, Public Service Announcements, and/or online and social media sites. The use of this information shall be at the sole discretion of BBBSA and/or its affiliates.

I further grant to BBBSA and its affiliates the absolute right to use the Released Material in whole or in part, alone or in conjunction with any other image, name, writings or reproduction, in color or otherwise, for art, advertising, business, trade, or any other lawful purpose whatsoever, in perpetuity throughout the world.

I understand and agree that all materials created by BBBSA and/or its affiliates that use the Released Materials are the property of and are owned by BBBSA, and that I cannot authorize their use by any other party.  I further understand that BBBSA may authorize their use by a third party. I hereby irrevocably transfer and assign to BBBSA my entire right, title and interest, if any, in and to the Released Materials and all copyrights in the Released Materials arising in any jurisdiction throughout the world, including the right to register and sue to enforce such copyrights against infringers.

I acknowledge and agree that I have no right to review or approve the Released Materials before they are used by BBBSA and/or its affiliates, and that BBBSA has no liability to me for any editing or alteration of the Released Materials or for any distortion or other effects resulting from BBBSA’s and/or its affiliates’ editing, alteration or use of the Released Materials.  BBBSA has no obligation to use the Released Materials or to exercise any rights given by this Consent and Release Form.

I hereby release BBBSA and its affiliates, employees, and agents, as well as any partner companies, from all claims, demands or liabilities and related financial costs that I may now or hereafter have arising in connection with BBBSA’s exercise of the rights hereby granted, and/or with the appearance or the Released Materials in any publication or production. These include, without limitation, claims for compensation, defamation, or invasion of privacy, or other infringements or violations of personal or property rights of any sort whatsoever.

Child Safety Guidelines and Ground Rules for Volunteers                                                                      

Child Safety Guidelines for Volunteers

1. Maintain Appropriate Boundaries

  • Never engage in any behavior that could be interpreted as inappropriate (e.g., physical affection that is not mutual or culturally appropriate).

  • Avoid situations where you are alone in a private space with your Little (e.g., bedrooms, hotel rooms, behind closed doors).

  • Avoid giving gifts, money, or privileges that have not been approved by BBBS staff.

2. Report Concerns Immediately

  • Report any suspicion or disclosure of abuse, neglect, or safety concerns to BBBS staff immediately.

  • Do not promise secrecy to a child. If a Little confides in you, listen carefully and report to BBBS.

3. Supervised Communication & Contact

  • All match activities should be approved by the child’s parent/guardian and discussed with BBBS staff as needed.

  • Avoid excessive or secretive communication via text, email, or social media.

  • Overnight visits are not allowed unless expressly permitted by BBBS policy and approved by staff and parents.

4. Respect Physical & Emotional Safety

  • Never use physical discipline, threats, or aggressive language.

  • Avoid risky physical activities (e.g., water sports, roughhousing, or driving long distances without approval).

  • Refrain from discussing topics that are not age-appropriate (e.g., sex, drugs, politics, religion unless part of an approved conversation).

5. No Substance Use

  • Do not use alcohol, tobacco, or drugs during outings or prior to meeting with your Little.

  • Never allow your Little to be exposed to these substances.

6. Safe Transportation

  • Only transport your Little when approved by BBBS and the child’s guardian.

  • Always follow state/local safety laws (e.g., seatbelts, car seats).

  • No texting or calling while driving.

7. Keep Staff in the Loop

  • Maintain regular contact with your Match Support Specialist.

  • Notify BBBS of any major changes in the relationship, your life, or any incidents involving your Little.


Ground Rules for Volunteers

  1. Be Reliable

    • Follow through on commitments. If you set a date/time with your Little, show up on time or communicate if something changes.

  2. Respect the Role

    • You are a mentor, not a parent, therapist, or peer. Focus on being a consistent, supportive adult figure.

  3. Respect the Family

    • Communicate openly and respectfully with your Little’s parent/guardian.

    • Never criticize or speak negatively about the child’s family.

  4. Keep It Age-Appropriate

    • All conversations and activities should be suitable for the child’s age and maturity level.

  5. Avoid Gift-Giving

    • Gift-giving should be limited, occasional, and approved by BBBS staff. Excessive gifts can create unfair expectations or dependency.

  6. Use Technology Responsibly

    • Follow BBBS social media and electronic communication guidelines.

    • Never post photos or personal information about your Little online without consent.

  7. Encourage Growth, Not Dependency

    • Your role is to help your Little build confidence and independence—not to “rescue” or fix problems.

  8. Be a Positive Role Model

    • Model respectful behavior, good judgment, and healthy habits.

  9. Stay Involved with BBBS

    • Complete required trainings and match updates.

    • Ask questions when in doubt—your Match Support Specialist is there to help.

  10. End Matches Respectfully

  • If a match must end, work with BBBS staff to ensure a healthy closure process.

Application Acknowledgement

I understand that this is an application for a 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.  

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