Mentee Application- The Little Brotherhood

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. 
The Little Brotherhood
The Little Brotherhood is a group mentoring program designed for boys, typically ages 8–14, who are currently waiting to be matched with a one-to-one Mentor. The program brings youth together monthly in a supportive, structured setting where they engage in hands-on activities and discussions focused on building confidence, communication, teamwork, and positive decision-making skills. Sessions are led by BBBSRI staff and often include community partners and volunteer mentors who serve as positive male role models. Little Brotherhood provides an opportunity for youth to begin building meaningful connections, strengthen social-emotional skills, and experience the impact of mentorship while they await a long-term match. 
Hidden Fields
To look up the owner's email for notifications
For notifications
Youth Information
Enter a date in the following format: mm/dd/yyyy
This is the year the youth will graduate.
Guardian Information
Type NA if unemployed
Family Information

Physical Address
Emergency Contact
If we are unable to reach you, who is someone we could call who always knows how to reach you?

Additional Questions


























Parent/Guardian Agreement

By checking the box below and providing my signature at the end of this form, I give permission:
  1. I am enrolling my child in, and granting permission for my child to participate in, BBBSRI’s mentoring programs, events, and activities.
  2. My child will participate in an in-person intake interview conducted by Big Brothers Big Sisters of Rhode Island staff and will complete questionnaires throughout their time in the program that may include questions about school, home life, and personal interests.
  3. My child will speak with a Big Brothers Big Sisters of Rhode Island staff member about personal safety.

  4. Big Brothers Big Sisters of Rhode Island is not obligated to match my child and may deny an application or close a match at any time. To protect the confidentiality and safety of all participants, the agency is not required to disclose the reasons for such decisions.

  5. I agree to timely communication and follow-up with agency staff as required.

  6. I agree to complete surveys during my participation in the program to support evaluation and continuous improvement of services.

  7. It is my responsibility to notify the agency of any changes to the information provided during the application or enrollment process (including, but not limited to, address, phone number, auto insurance status, or new criminal charges).

  8. I understand that certain relevant information about me, my family, and my child may be shared with a prospective volunteer mentor for matching purposes. This may include demographic information, preferences, and information relevant to my child’s safety and well-being.

  9. I understand that disclosures of suspected child abuse or neglect, past or present, made to BBBSRI staff will be reported to the appropriate authorities in accordance with mandatory reporting laws.

  10. I understand that the information I provide during the enrollment process will be kept confidential, unless disclosure is required by law.

  11. As part of the enrollment process, I will be required to provide additional personal information, including participation in an in-person interview.

Informed Consent

What to Expect

Big Brothers Big Sisters of RI mission is to create and support one-to-one mentoring relationships that ignite the power and promise of youth. Participation in our Program is voluntary. However, it is expected that all participants are able and willing to commit to our Program, at least for a period of 18 months.


Risks

Before giving your consent to participate in our Program, it is important that you are informed of possible risks:

  • Participants understand that the program is not obligated to match their child with a volunteer, and that as part of the enrollment process they will be asked to provide additional information through an in-person interview.
  • Participants understand that certain relevant information about their child will be discussed with the volunteer who is a prospective match (i.e. demographic information, information relevant to volunteer preferences, and information relevant to child-safety and well-being).
  • Participants understand that their child may be matched to a mentor within weeks, or it may take months, dependent on mentor pool available and expressed personal preferences.
  • Participants understand that the information they provide in the enrollment process, in person or virtually, will be kept confidential, unless disclosure is required by law and with exceptions noted (see limits to confidentiality below).
  • Participants understand that their match may close prematurely. 
Social Media

Program staff are prohibited from engaging in a personal and virtual relationship, via social media outlets (Facebook, Instagram, Tik Tok, Snapchat, etc.) with Program participants (Bigs, Littles & families). Additionally, Mentors, Mentees/families are prohibited from engaging in a virtual relationship, via social media outlets (Facebook, Instagram, Tik Tok, Snapchat, etc.), between each other.

Records

Legally and ethically, we are required to keep records of all our interactions with participants. Records are considered the property of BBBSRI. Participants' personal records are stored in a secure national database and only authorized staff have access to those records. Legally, you have right to see all information generated between us. You must provide explicit permission for information to be revealed, unless the law specifies otherwise (see exceptions to confidentiality). Thus, with your written consent, we will provide information to anyone with legitimate need. You are also entitled to a copy of any records generated by BBBSRI. BBBSRI keeps records for 7 years past the date of the last contact. Then, because of space and privacy concerns, records are destroyed in compliance with state law and professional ethics.

Rights and Responsibilities


YOU HAVE CERTAIN RIGHTS AS A CLIENT/PARTICIPANT OR AS A PERSON REQUESTING SERVICES FROM BIG BROTHERS BIG SISTERS OF RHODE ISLAND (BBBSRI).
 

YOU HAVE THE FOLLOWING GENERAL RIGHTS:

  • To be informed of your rights during orientation/enrollment, whenever BBBSRI makes a change in the rights of persons served, and upon your verbal or written request.
  • To be encouraged and assisted throughout services to exercise your rights and to voice opinions and recommendations about services and policies offered by BBBSRI without fear of discrimination, restraint, interference or recrimination.
  • To receive services in a language and manner you can understand.
  • To be informed, verbally and/or in writing, of what is expected of you as a client.
  • To receive assistance in resolving issues and assistance in accessing alternative services.


YOU HAVE THE RIGHT TO SERVICE PROVIDED WITH RESPECT, DIGNITY, AND PRIVACY:

  • To receive services that are considerate and respectful of your values and beliefs.
  • To privacy, security and confidentiality of information, as specified by all Federal and State laws and BBBSRI policy.
  • To receive services in an environment free of abuse, neglect, mistreatment, financial exploitation, threats, and/or any human rights violation, as well as to be protected from any and all forms of coercion.

YOU HAVE THE RIGHT TO BE INFORMED OF AND PARTICIPATE IN TREATMENT AND/OR SERVICE DECISIONS:

  • To be informed of the policies, changes and addendums, regarding informed consent to participate in the agency’s services.
  • To be informed about what to expect during the program and/or service process.
  • To be informed about, and to participate in, decisions regarding services and to receive, at minimum, the information to facilitate informed decision-making, including limitations on confidentiality; ongoing progress/status regarding program goals and objectives, services or interventions, when appropriate; projected end date of services.
  • To terminate services/program participation at any time.


YOU HAVE THE RIGHT TO YOUR CLIENT RECORD INFORMATION:

  • To provide authorization or to refuse to provide authorization for the release of confidential information to family members, service providers, except when BBBSRI is required by applicable state and federal law to disclose such information.
  • To receive a copy of all authorizations for release of confidential information that you have approved.


YOU HAVE THE FOLLOWING RESPONSIBLITIES AS A CLIENT/PARTICIPANT OF BBBSRI:

  • To provide accurate information about yourself and your child or children that is relevant to your participation in the program.
  • To be familiar with your rights and responsibilities.
  • To attend and participate in all appointments (interview/ match support), in person or via phone, or give adequate prior notice of cancellation.
  • To speak and engage with my Match Support Specialist as often as required and will return phone calls within 24-48 hours.
  • To comply with the rules of the specific program to which you are assigned.
  • To treat other participants and staff respectfully.
  • To respect the privacy of other participants.
  • To act as an ambassador of BBBSRI programs and to represent yourself and the agency if a positive manner.

A copy of Client Rights and Responsibilities is provided to you when you begin receiving services. A copy may also be obtained by calling  (401) 921-2434 Ext 101.

Client Code of Conduct 

Big Brothers Big Sisters of RI (BBBSRI) adopts this Code of Conduct to define acceptable standards of behavior for Parents/Guardians, Littles, and Bigs (participants) and to provide a procedure for action whenever there are grounds to end services because participants have engaged in disruptive and/or unacceptable behavior.


As documented on the Rights and Responsibilities contract, BBBSRI is responsible for providing all participants with a rewarding and safe environment. Therefore it is expected that all participants will:

  1. Treat staff, families, volunteers and other participants with respect & honesty.
  2. Refrain from discriminatory comments or actions in regards to sexism, racism, ableism, classism, homophobia, biphobia, transphobia and any other behavior that is derogatory to a marginalized person(s) in our community.
  3. Inform staff of needs and changes in circumstances in order to receive relevant services.
  4. Understand that BBBSRI works with many individuals with many levels of needs, and staff may need to prioritize their time to deal with emergency or high need situations.
  5. Maintain confidentiality of other clients, volunteers and staff.
  6. Understand that BBBSRI and its staff has limitations in regards to the services they provide.
  7. Realize that access to services may have limits and eligibility does not automatically ensure services.
  8. Deal with problems and concerns in a mature manner according to BBBSRI Policies and Procedures.

Refusal of Service


Participants have a responsibility to be respectful and considerate of other participants, and staff at BBBSRI. The decision to refuse, suspend or terminate service is made by the Leadership Team. Wherever possible, if a participant is refused service, that service user is provided with a list of other community resources.


Reasons for refusal, suspension or termination of services:

  1. When the Leadership Team and staff agree that a client/participant has violated the above Code of Conduct.
  2. When a participant does not adhere or violates Program policies and procedures.
  3. When a participant is or is perceived to be threatening, harmful, or inappropriate to fellow participants or staff.
  4. When a participant behaves violently in any real or perceived manner.
  5. When a participant is or is perceived to be threatening or obscene in interaction with staff or other participants.

Confidentiality Policy

In order for Big Brothers Big Sisters of Rhode Island to serve our clients in a responsible way, we must ask mentors, mentees and parents/guardians a series of questions, many of which are personal in nature. The agency respects the confidentiality of this information and, with the exception of situations listed below, shares it only among the agency professional staff. The right to confidentiality applies not only to written records, but to video, film, pictures or use of names in agency publications.

Limits of Confidentiality

  1. Information will only be released to other individuals or organizations if an authorized "Consent To Release Information" form has been signed by the mentor or parent/guardian.
  2. Names and photos of mentors and mentees (first name only) may be used in agency publications or promotional materials only if release form has been signed.
  3. For purposes of program evaluation, audit, or accreditation with certain outside entities such as Big Brothers Big Sisters of America. Outside parties are required to respect confidentiality and may only use information for the purposes stated.
  4. Information will not be provided to law enforcement officials, legal counsel or the courts without a valid and enforceable subpoena.
  5. Rhode Island State law mandates that suspected child abuse or neglect be reported to the Department for Children, Youth & Families. All Program Staff are required to comply with mandated procedures.
  6. If any agency staff receives information indicating that a mentor or mentee may be dangerous to himself or herself or to others, necessary steps will be taken to protect the party at risk. This may include a medical referral or a report to the local law enforcement authorities.

Application Acknowledgement


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 childs application. 

I understand that information contained in my application will be verified by Big Brothers Big Sisters. 

I understand to provide timely, high-quality customer service, BBBSRI utilizes AI and automated tools to assist professional staff in managing data and communications. All final determinations regarding participant eligibility, suitability, and matching are made solely by trained agency professionals.

I understand that once my application is received, BBBSRI will provide me with a Parent Handbook. It is my responsibility to review and understand all program policies.


My signature below certifies that I am granting my child to participate in Big Brothers Big Sisters of Rhode Island's mentoring programs and I have read and agree to all policies and consents listed in this application.


Contact Information