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. 

Basic Information







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Employer Information


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Additional Information





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Questionnaire



















Previous Experience



Interest Poll


Other Questions






Agency Policy on All Mentoring Volunteers








References

Please provide at least four references. A reference from a Spouse or Significant Other is required. Substitute a family member if no Spouse/Significant Other.
Spousal/Familial Reference







Professional Reference






Personal Reference






Personal Reference







Volunteer Experience










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The next few pages include agreements and BBBS forms. Keep going, your form is nearly complete.

Media Consent and Release



Confidentiality Policy 

Big Brothers Big Sisters Services, Inc. respects the confidentiality of client and volunteer records and, with the exception of situations listed below, shares information about clients and volunteers only among the agency professional staff.

 

All records are considered the property of the agency and not the agency workers or clients or volunteers themselves.  Records are not available for review by the clients or volunteers.

  •  Information will be released to other individuals or non-BBBS organizations only with the client or volunteer’s written consent or with the understanding that the respective parties have agreed to adhere to this confidentiality policy.

  • Big Brothers Big Sisters Services, Inc. has permission to use the client or volunteer’s name and photograph for the purpose of promoting the agency.  Such use may occur before, during, and/or after participation in the program.  Big Brothers Big Sisters Services, Inc. and their nominees and designees are hereby released from any obligation or liability in connection with any personal or proprietary rights as a result of the sale, reproduction or use of the above-referenced identifying information. 

  •  For purposes of program evaluation, audit, or accreditation, and with the prior approval of the Board of Directors, certain outside bodies such as Big Brothers Big Sisters of America may have access to client and volunteer records.

  • Members of the Board of Directors or evaluators appointed by the board have access to client files upon authorization of the Board of Directors.

  • Information shall only be provided to law enforcement officials of the courts pursuant to a valid and enforceable subpoena.

  • Information shall be provided to an agency’s legal counsel in the event of litigation or potential litigation involving the agency.

  • State law mandates that suspected child abuse be reported to the appropriate authorities (Virginia Department of Child Protective Services Hotline 1-800-552-7096).

  • If an agency worker receives information indicating that a client or volunteer may be dangerous to himself or herself or to others, necessary steps may be taken to protect the appropriate party.  This may include medical referral or report to the local law enforcement authorities.

  • At the time a child or volunteer is considered as a match candidate, information is shared between the prospective match parties.  The information about the volunteer may include such items as: age, sex, religion, interests, hobbies, marriage, family status, sexual orientation, living situation, etc.  Information about the child may include such items as: age, sex, race, religion, interests, hobbies, family situation, etc.

  • The client or volunteer agrees not to disclose personal information about the respective parties to anyone outside of the agency.



My consent below indicates that I have answered all questions on this page truthfully. I am aware that according to Big Brothers Big Sisters Services, Inc. my status as a volunteer makes me a mandated reporter of any suspicion of child abuse and/or neglect.

 

My consent at the bottom of this page also indicates that I promise to abide by the Code of Conduct for volunteers of Big Brothers Big Sisters Services, Inc.:

  • To avoid the use of tobacco products when in the company of my Little.

  • To refrain from ingesting any alcoholic beverage prior to or during my visits with my Little.
  • To never use illegal drugs at any time.
  • To use no form of physical or verbal abuse (including corporal punishment) against my Little.
  • To have no form of sexual contact between myself and my Little or their family members (includes nudity).




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