Site-Based Big Brothers Big Sisters Volunteer Application

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.

Hidden Fields

Contact ID 18 Character

Enrollment ID 18 Character

Contact Owner ID

Contact Owner Email

Basic Information

First Name

Middle Name

Last Name

Maiden/Alias

input NA if none

Preferred Name

Birthdate

Social Security Number

If uncomfortable entering, leave blank and we will call when we run the background check to get your SSN over the phone

Gender

How do you identify?

Sexual Orientation

How do you identify?

Personal Pronouns

What pronouns do you use?

Race/Ethnicity

American Indian or Alaska Native	Asian - Chinese
Asian - Filipino	Asian - Indian
Asian - Japanese	Asian - Korean
Asian - Other	Asian - Vietnamese
Black or African American	Hispanic - Cuban
Hispanic - Mexican,Mexican American,Chicano	Hispanic - Other Latinx or Spanish origin
Hispanic - Puerto Rican	Middle Eastern or North African
Pacific Islander - Chamorro	Pacific Islander - Native Hawaiian
Pacific Islander - Other	Pacific Islander - Samoan
White or Caucasian	Other
Prefer not to say

Tribal & Regional Corporation Affiliations

Nationality

To select multiple, hold CTRL/CMD and click.

Relationship Status

How did you hear about Big Brothers Big Sisters?

Contact Information

Personal Email

Work Email

Alternate Email

Preferred Email

Mobile Phone

Work Phone

Work Phone Extension

Home Phone

Alternate Phone

Preferred Phone

Best Time to Call

In general, do you prefer to be contacted by email or phone?

Mailing Address

Mailing Street Address

Mailing City

Mailing State

Mailing Zip Code

Mailing address is different from residential address

Street Address

City

State

Zip Code

Emergency Contact Information

Name

Phone

Relationship

Employer Information

Are you currently employed?

Occupation

Name of Employer

Employment Length (Months)

Employment Length (Years)

Employer Address Line 1

Address Line 2

City

State

Postal Code

Is it okay to call at work?

YesNo

Additional Information

Level of Education

Year Degree Obtained

Education Years Completed

Have you served in the military?

Which activities do you enjoy more?

Which Site Are You Interested In?

References and Background Check

Previous Experience

Have you previously applied to be or served as a Big here or anywhere else?

YesNo

When?

Where?

Have you ever been involved with Big Brothers Big Sisters in a capacity other than a Big?

YesNo

When?

Where?

Have you ever been denied acceptance or released from service as a volunteer or employee or another Big Brothers Big Sisters Program for another youth-serving organization?

YesNo

When?

Where?

Have you ever actively volunteered or worked with youth before? (as a Big or otherwise)

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 (must use spouse/partner if applicable)

Spousal/Familial Reference ID

First Name

Last Name

Email

Phone

Relationship to you

Years Known

Professional Reference

Professional Reference ID

First Name

Last Name

Email

Phone

Relationship to you

Years Known

Minimum 1 year

Personal Reference

Personal Reference ID

First Name

Last Name

Email

Phone

Relationship to you

Years Known

Minimum 2 years

I consent to and understand that:

The references and youth-serving organization(s) I listed may be contacted by mail, telephone, email, or in person;
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, military records, and other records where required by local, state, or federal law for volunteers working with youth;
I will be required to complete a renewal background check every 3 years, as long as I am a volunteer with BBBS;
I am in no way obligated to perform any volunteer services;
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;
Other BBBS agencies and youth organizations where I have worked or volunteered may be contacted as references;
As part of the enrollment processes, I will be required to provide additional personal information, including completion of an in-person interview;
I understand that the information I provide in the enrollment process will be kept confidential, unless disclosure is required by law.
I understand that detailed accounts of child abuse or neglect, past or present, will be reported to proper authorities;
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);
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.)
I agree to complete questionnaires throughout my time in the program to evaluate and improve program services;
I agree to timely communication and follow-up with all agency staff as required by the agency.
As of January 2022, the State of California requires that all volunteers who work with children go through a training to learn about child abuse and reporting. I will be required to complete an online child safety training in order to volunteer.

I consent to these terms and conditions, including the preparation and release of background reports to Big Brothers Big Sisters of America and its designated representatives.

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.

Do you have any concerns about your ability to fulfill the school year (1-4 hours/month) commitment required of mentors?

YesNo

Do you anticipate any significant life changes over the next year or have you had any this past year? (ie. job or schedule changes, moving, new family member, etc.)

YesNo

Please describe:

Are you currently, or have you in the past 3 years, received counseling or therapy for mental health purposes?

YesNo

Have you ever been accused, arrested, charged, or convicted of a crime?

YesNo

Please describe, including conviction date if applicable:

What languages do you speak fluently? (select all that apply)

African Languages (Swahili, Bantu)	American Sign Language
Arabic	Asian: Other
Chinese	Creole
Dutch	Eastern European (Czech, Slovak)
English	French
German	Greek
Hebrew	Hmong
Indian (Hindi, Punjabi)	Italian
Japanese	Keres (West)
Korean	Lao
Nordic	Persian
Portuguese	Russian
Spanish	Turkish

Confidentiality Agreement

Big Brothers Big Sisters of the Greater Sacramento Area, Inc. (“BBBS”) is committed to maintaining the confidentiality of its clients and volunteers. All client and volunteer information and records are the property of BBBS. No client, volunteer, or BBBS staff member shall have access to such information, except as authorized by agency policy and procedure. As such, records are not available for review by clients or volunteers. All BBBS staff and volunteers shall use reasonable care to provide for the secure storage of all confidential information.

“Confidential information” includes, but is not limited to:

Any and all client or volunteer data, including personally identifiable information, such as names, addresses, phone numbers, social security numbers, photographs, digital images, and likeness; any information provided to BBBS by a client or volunteer, including but not limited to electronic information, documents, and software; the financial information of any BBBS client or volunteer; any individually identifiable health information of a client or volunteer, including information related to a physical or mental health condition, or information received from a healthcare provider, healthcare plan, or related entity.

Confidential information will be shared only on a need to know basis among BBBS staff or pursuant to the following exceptions:

1. Release of information to third parties upon receipt of signed authorized consent by the volunteer or the client’s parent or legal guardian;

2. Release of certain identifying information regarding clients and volunteers, such as names, photographs, voice, and/or likeness in BBBS’s publications and promotional material, including online and in print, upon receipt of this form signed by such person(s) or their parent or legal guardian, as this form serves as signed consent;

3. Release of records for purposes of a Board-approved program evaluation, audit, or accreditation;

4. Release of records to the Board of Directors upon authorization by formal motion of the Board;

5. Release of information and records to BBBS’s legal counsel;

6. Release of applicable information to prospective and active match parties;

7. Release of applicable information for the purpose of case consultation with Board-authorized professionals;

8. Release of relevant information in the event BBBS receives information indicating that a client or volunteer may be dangerous to himself/herself or others, in order to protect the appropriate person(s) (which may include a medical referral or report to the local law enforcement authorities); and

9. Release of information or records as otherwise required by law.

I have read and understand the above information provided to me regarding Big Brothers Big Sisters' confidentiality policy. I agree by the conditions set forth.

Social Media Guidelines for Volunteers

BBBS supports internet safety. The match should be together for at least 90 days before submitting a social media permission form for approval. While matched in our program, “friending” each other on Facebook or any other social media is strongly discouraged. Volunteers must get parent’s permission to post any pictures or information on social media/internet regarding the child. The child’s last name or location should NEVER be used when posting any information

I have read, understand, and agree to follow the above guidelines.

Publicity and promotional materials for Big Brothers Big Sisters are conducted in a variety of forms. May we use your name, image, likeness, appearance, or basic biographical information in these materials?

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.

I have read this Consent and Release Form completely. I fully understand what it means, and I agree to its terms. I have not been offered any additional consideration or enticement, nor have I been coerced to sign this document. I am voluntarily signing it for the purposes and considerations described.

Bigs Guidelines and Ground Rules

The agency has guidelines that are important for you to follow. These guidelines are designed to help you be successful and to protect you, the agency and the child. Failure to comply with the guidelines may result in termination of your match.

You must contact your Match Support Specialist monthly. Please let your Match Support Specialist know what challenges you encounter and your positive experiences. This will help prevent a little issue from becoming a big one.
Make a practice of seeing your Little about 2 times per month, not less and not too much more. This is to ensure that your Little won’t be disappointed if you are unable to see them more than 4 times per month.
Strive for free or low-costing activities, and while tempting, try not to give the child extra gifts. Use money sparingly, it is your friendship that is truly important.
Get to know your Little gradually and naturally. Don’t feel pressured to rush your friendship.
Be consistent and dependable. Your Little must learn to trust you, so avoid being late, breaking dates or making promises you are unable to keep.
Let your Little know when you will see them again. Try not to keep them guessing.
Encourage your Little to share in making decisions about the activities in which the two of you engage. Giving options from which the child can choose may help build the child’s ability to make decisions and will help you set boundaries.
Children learn by problem solving. Work with your Little and set realistic directions and goals. Try to make the achievement fun for them.
Try not to expect a “thank you.” Some children find it difficult to express their appreciation. Your Little will learn to show appreciation by hearing you say “thank you” and watching your behavior.
If giving advice, always be supportive of the parent, even when you disagree. Don’t make judgments concerning any family situations. It is, however, appropriate for the Big to correct misbehavior within the context of the relationship, but do not interfere if the parent disciplines the Little in your presence.
Do not discipline your Little. Avoid discussing a situation or problems concerning your Little in front of him or her. If you need to discuss a situation with the parent, it should be done privately. If the child’s safety is in question, you must contact your Match Support Specialist immediately.
Keep your knowledge about your Little and his or her family confidential.
Do not feel socially responsible to the family of your Little. For example, do not feel obligated to accept invitations from the parent or child’s other family members. Feel free to say no to any and all requests.
Respect your Little’s family values. Be aware of your own values and how they may conflict with the parent’s values.
If for any reason you decide you want to try to close your match, first discuss the situation with your Match Support Specialist, who will help you work with the parent and child to address the situation or will help facilitate a positive match closure.

I have read the above requirements, which define my responsibilities as a volunteer with Big Brothers Big Sisters. I agree to abide by them as long as I am in the program.

Code of Conduct

BBBS-GSA is committed to creating a safe, respectful, and rewarding environment for all participants - Parents/Guardians, Littles, and Bigs. This Code of Conduct outlines expectations for behaviors and provides guidelines for addressing disruptive or inappropriate conduct that may lead to the suspension or termination of services.

As outlined in the Rights and Responsibilities Agreement, BBBSGSA holds the responsibility to ensure a positive experience for everyone involved in the program. To support this, all participants are expected to:

Expectations for All Participants

Show Respect and Honesty: Interact respectfully and truthfully with staff, families, volunteers, and fellow participants.
Promote Inclusion and Equity: Avoid discriminatory comments or actions, including those based on race, gender, ability, socioeconomic status, or sexual orientation. Behavior that marginalizes others is not tolerate.
Communicate Needs: Keep staff informed of any changes in circumstances or needs to ensure appropriate and timely support.
Recognize Staff Prioritization: Understand that staff serve a wide range of participants with varying needs and may prioritize urgent or high-need situations.
Respect Privacy: Maintain the confidentiality of other clients, volunteers, and staff.
Understand Service Limits: Be aware that eligibility does not guarantee services, as resources may be limited.
Address Issues Appropriately: Raise concerns or problems in a respectful and mature manner, following BBBS GSA policies and procedures.

Refusal, Suspension, or Termination of Services

Participants are expected to always behave in a respectful and considerate manner. Decisions to deny, suspend, or end services are made by staff in consultation with Senior Leadership. When possible, participants who are no longer eligible for services will be provided referrals to other community resources.

Reason for Refusal, Suspension, or Termination of Services:

Violation of the Code of Conduct.
Failure to follow program rules, policies, or procedures.
Behavior deemed threatening, harmful, or inappropriate towards others.
Any form of actual or perceived violence.
Use of threatening, obscene, or abusive language or behavior towards staff or participants.

I have read and understand the above information provided to me regarding Big Brothers Big Sisters' Code of Conduct. I agree to the conditions set forth.

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 that you will be accepted and/or matched in the program.

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.

I have answered these questions honestly and completely to the best of my knowledge.

Contact Information