BBBSCHI SITE BASED VOLUNTEER APPLICATION

Volunteer Minimum Requirements

Check EACH item on the list below to confirm you meet the minimum volunteer requirements:

I am at least 18 years old.I meet one of the following residency criteria:

1. Be a US citizen and lived in the US at least 12 months prior to applying

2. Be a legal US resident for the past 2 years

3. Have a valid student or workers visa for the past 2 years

I can commit to a minimum of a 1 year relationship. I can commit to attending, at minimum, 80% of program sessions.I allow the agency to conduct a thorough Criminal Background Check and Public Domain Search.I am willing to disclose and discuss current and previous medical and mental health conditions in a confidential manner with the Big Brothers Big Sisters staff member who conducts my enrollment interview.

IMPORTANT NOTES:

BBBSChi is an official Chicago Public Schools (CPS) Vendor and also has an official partnership with Noble Network. For this reason, you may be asked to complete additional fingerprint background checks and provide tuberculosis (TB) test results at any time during the enrollment or matching process to remain in compliance with our partnerships.

Program meetings, as well as enrollment and training for participants, may take place either in-person or virtually, depending on the program model and partner site. Matches are encouraged to communicate with one another between sessions to strengthen relationship building. Program format (in-person, virtual, or hybrid) may vary by site and is subject to change based on organizational needs and partner requirements.

Thank you.

--BBBSChi Staff

I have read and understand the above two statements.

Program Name (Site Preference) Selection

Program Type Preference

For which site location/program are you applying?

Please refer to the program name in the email from your recruiter or other BBBS Staff.

Site Account ID

Site Location

Populated upon program site selection

IMPORTANT: Please be sure to select the correct program. If your company or college/university has a partnership with BBBS, please ensure you are choosing your respective program. If you are unsure, please contact our recruitment staff.

UChicago Requirement

As an official CPS vendor and by joining the DWS or West Monroe Partners Workplace programs, you will be required to complete fingerprinting. Shortly after submitting your application, you will be contacted by UChicago Charter with more information. PLEASE SUBMIT A COPY OF YOUR RECEIPT TO BOTH YOUR INTERVIEWER AT BBBSCHI & UCHICAGO STAFF. THANK YOU!

Referral Detail

Which BBBS staff or current Big referred you?

Type 'BBBS Board/Staff' or 'Big Champions'...then select the staff name who referred you.

Referral Detail ID

Volunteer Information

Contact ID 18 Character

Enrollment ID 18 Character

Contact Owner ID

Contact Owner Email

First Name

Middle Name

Last Name

Maiden/Alias

Input N/A if none

Preferred Name

Birthdate

Gender

Gender Write In

Preferred Pronouns

What are your pronouns?

Sexual Orientation

How do you identify?

Relationship Status

Social Security Number

Note: Your social security number is required to run a background check. Please do not enter only 0's as this will delay the processing of your application.

Nationality

Race/Ethnicity

Press & hold CTRL to select multiple options.

Contact Information

Mobile Phone

Home Phone

Alternate Phone

Work Phone

Work Ext.

Personal Email

Work Email

If no work email, enter personal again.

Alternate Email

Preferred Email

Preferred Phone

Best Time to Call

Contact Preference

Mailing Address

Mailing Street Address

Mailing City

Mailing State

Mailing Zip Code

Mailing address is different from residential address

Physical Address

Street Address

City

State

Zip Code

Emergency Contact Information

Name

Phone

Relationship

Employer Information

Employment Status

Name of Employer

Occupation

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

Have you served in the military?

What languages do you speak, if any (other than English?

References

Please provide at least two (2) references. A reference from a Spouse/Spousal Equivalent or Significant Other is required. Substitute a family member if no Spouse/Spousal Equivalent or Significant Other.

Spousal/Familial Reference

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

Personal Reference

Personal Reference ID

First Name

Last Name

Email

Phone

Relationship to you

Years Known

Have you held a volunteer or paid position where you worked with children in the last five years? (for example counselor at a camp, babysitting, nannying, coaching, etc.)

Volunteer Experience

YSO Reference ID

Organization Name

Location

Start Date

End Date

Direct Supervisor First Name

Direct Supervisor Last Name

Phone

Email

Years Known

Reason for Leaving

Consent & Release

Please read each item.

______I authorize Big Brothers Big Sisters of Metropolitan Chicago ("BBBSChi "), its staff and its agents, to investigate my background, health, character and personal history in any manner it sees fit, and, I authorize all persons, companies, schools, law enforcement, and other agencies to release to BBBSChi all information concerning such subjects and otherwise concerning my suitability to become a volunteer. I understand that this may include, but is not limited to, an arrest record check through the Illinois State Police and a driving record check through the Illinois Secretary of State's Office. I also understand this information will be used to determine my eligibility to be a Big Brother/Big Sister. I understand that if I am accepted to be a volunteer, BBBSChi will conduct ongoing criminal background and driving record checks periodically while I remain a volunteer.

______I, for myself, my heirs, executors and administrators, hereby release and forever discharge BBBSChi , its officers, directors, employees and agents, and all other personnel, companies, schools, organizations, law enforcement and other agencies and their officers, directors, employees and agents from any and all causes of action, suits, damages, liabilities, costs, debts, sums of money, claims and demands of any sort whatsoever, and any and all related attorney's fees, court costs and other expenses, in each case that result from or relate to my relationship with any youth I volunteer to mentor or that otherwise result from or relate to my services as a volunteer or my application to become a volunteer. I acknowledge that my services as a volunteer may include activities in areas that may have a higher than average incidence of crime, and the foregoing release and discharge covers, without limitation, any damages or injury I may sustain while engaged in activities related to BBBSChi .

______I give permission for any staff member of BBBSChi to review all information contained in my volunteer file for the purpose of matching, evaluation, program audit and staff training. I also give permission to BBBSChi 's Program Committee and to the staff and agents of Big Brothers Big Sisters of America to review my volunteer file in connection with their periodic audit for purposes of evaluation.

______I understand that all information obtained from me or about me will be held in confidence by BBBSChi . I will only have access to my application. All other information concerning me, including but not limited to information derived from my references, the investigative process, interviews or otherwise, will be the sole property of BBBSChi . BBBSChi will not release to outside sources, unless required by law, information from my volunteer file other than verification that I am a volunteer, without my prior written consent.

_____I irrevocably consent to any and all uses and displays of my name, image, likeness, appearance, and basic biographical information in, on, or in connection with any advertising, publicity, marketing, or printed or electronic media, of any type, throughout the world at any time by Big Brothers Big Sisters of America, [BBBSA affiliate], and any of their affiliates, successors, partners, sponsors, donors, and any entities or persons with whom they conduct any public relations, marketing, or fund raising of any type, without further consent from me or without any royalty, payment, or other compensation to me, without any royalty, payment, or other compensation to me or Minor Child, and with the release and waiver of any claims, actions, damages, losses, costs, expenses and liability of any kind arising from any such use.

**If you do not want to consent to media/social media release, please inform a BBBSChi staff member.

______I understand that as a BBBSChi volunteer I am required to notify BBBSChi promptly of any changes in the information I have provided during the application process that may alter my ability to serve in the capacity for which I have applied, including any changes in medical, psychological, or arrest history. I understand that such information may be released to the parent or guardian of a child with whom I am matched, and I consent to the release of such information.

______I understand that BBBSChi reserves the right to reject a candidate for any reason that BBBSChi , in its sole judgment, determines will or may affect either the best interests of a Little Brother/Little Sister or BBBSChi . Furthermore, BBBSChi reserves the right to withhold the reasons for such refusal.

I understand and consent to the above terms and conditions.