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, provide tuberculosis (TB) test results, and submit proof of Covid-19 vaccination at any time during the enrollment or matching process to remain in compliance with our partnerships.

Due to the pandemic, program meetings, as well as all enrollment and training for participants may be still be virtual. Matches are encouraged to communicate with one another between program sessions to enhance the relationship building process. Virtual programming may remain until in-person program sessions are safe to resume. This may vary by program.

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?

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!

BBBSChi receives funding from the Chicago Department of Family & Support Services (DFSS) to support our Mentor MeetUp Thursday and Near West Side programs. Due to this funding, there are a few additional requirements that we will need to have you complete prior to being matched in our program. 

1. All of our volunteers will need to complete Mandated Reporter Training. Use this link: Mandated Reporter Training to complete the online Mandated Reporter Training. Please save your certificate of completion and acknowledgment form to submit before your scheduled interview. Examples below.

cert acknow

2. Volunteers will also need to be fingerprinted. Use this link: https://www.biometricimpressions.com/locations/ to find a location near you and submit a copy of your receipt to your interviewer.

Referral Detail

Which BBBS staff referred you?

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

Chinese American Service League (CASL) Licensing Requirements

Per the licensing requirements stated by Chinese American Service League (CASL), in order to participate in programming, volunteers must provide proof of Covid-19 vaccination, as well as complete and submit the results for tuberculosis (TB) testing and a physical exam. You will be asked to submit these items to your BBBS interviewer prior to being matched and started in the mentoring program. Please also note that these results will be shared with CASL administration.

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

Year Degree Obtained

Enter N/A if not applicable

Education Years Completed

Have you served in the military?

Do you speak any languages other than English?

References

Please provide at least three (3) 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

BBBSChi COVID-19 WAIVER

In-Person Session Guidelines

Big Brothers Big Sisters of Metropolitan Chicago will allow matches in both Illinois and Indiana to take part in in-person sessions upon receipt of a signed waiver from both Big and Parent. Meeting with your match in-person outside of agency organized events continues to be against the Site Based program rules.

In-person sessions are at the discretion of each match and its participants. You may choose to

maintain a virtual relationship with your match and begin in-person group sessions once all match parties are comfortable.

If any party in the match relationship is at heightened risk for the Coronavirus, you should not meet in person at this time. This may also include family members, partners, or roommates. Heightened risk factors include age, respiratory illness, diabetes, immune system suppression, among many others.

Communicating about COVID-19 & Risk Factors in your Match

Each person in the match needs to assess their health directly before each session: Are you feeling achy? Fever or chills? Fatigued? Cough or tightness in chest? Before each session, all parties should do this self-evaluation and discuss with each other to determine if you should attend the group session. If not, opt for a virtual visit instead.
Share with your Program Coordinator if you or someone in your home has been exposed to someone with COVID-19 or had exposure to a large number of people.

We need to be open and honest with each other so we can protect one another and work together to make the best informed decision about a program session.

Program Coordinators will be clear on planned activities when communicating with match parties, and all match parties, including parents/guardians should communicate any restrictions they require and give specific approval to the session.
When together in-person with your match, remind each other about rules for the day.

How will we help keep each other safe? Are we wearing masks? Are we washing our hands? Check-in throughout your session.

Protocol for In-Person Group Sessions

Match parties must wear a mask at all times during sessions.

Your Program Coordinator will have extras with them in case someone doesn't have one or you are unable to find your own.

Wash and sanitize hands frequently.
Maintain at least 6 feet of distance.

BBBSChi COVID-19 Group Session Waiver

I have read the agency’s COVID-19 Match Contact Guidelines and I agree to adhere to all items listed to the best of my ability. I understand I am not obligated to attend the group session and have in-person contact with my match, and that I am expected to continue virtual contact if not having in-person contact.

I will make decisions based on what is best for the safety, health, and wellness of each person in my match and our families. I will discuss these considerations in depth with each person in my match and ensure we are all in agreement before proceeding.

If I have questions or concerns about how best to do this, or about any of the guidelines listed here or any other concerns related to the BBBS program, I will contact my Program Coordinator.

I will not hold Big Brothers Big Sisters of Metropolitan Chicago (BBBSChi) or its directors, officers or employees, responsible if I or one of my family members contracts COVID-19 or any illness. I will not hold Big Brothers Big Sisters of Metropolitan Chicago (BBBSChi) responsible for any damages that may result from contracting an illness, including all liability, claims or demands arising from any injury, disability, death, or loss or damage to person or property, whether arising from the negligence of the releases or otherwise, to the fullest extent permitted by law. This release is binding on heirs, executors, administrators, assigns, agents, attorneys and representatives.

I understand and agree to the above statement.

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.