I hereby certify that the information provided in this application is true and complete to the best of my knowledge and subject to verification by the agency. I understand that I am expected to follow all local, state and federal laws. I authorize the agency its affiliates and their representatives to investigate all information given and to secure additional information, if necessary. I understand that any misrepresentation or omission of a material fact on my application or during my interview process may be justification for refusal of volunteer placement, or if placed, will be grounds for dismissal without advance notice.

I understand that and consent to the following:

1)  The references and youth organizations I listed may be contacted by mail, telephone, text or email;

2)  I am in no way obligated to perform any volunteer services;

3)  I will notify my references and any youth serving organization that they should comply with Big Brothers Big Sisters request to complete a reference;

4)  The information I provided may be used to conduct a background check now and for as long as I am involved with the agency, to include driving records check, sex offender check, criminal background check, public domain check, and other records where required by local, state, or federal law for volunteers working with youth;

5)  In order for Big Brothers Big Sisters Lone Star (BBBSLS) agency to provide responsible and professional services, it is necessary for me, the volunteer, to disclose personal information.

6)  All records are considered property of the agency, not of agency staff, clients, parents/guardians, volunteers or authorized persons or representatives; Information from the application interview process, or match support process may be shared between BBBS and partnership agencies when applicable;

7)  Big Brothers and Big Sisters Volunteers, as well as the children BBBS serves, their parents/guardians, and BBBS staff and Board Members, are not excluded on the basis of race, religion, national origin, color, gender, marital status, sexual orientation, gender identity, veteran status, or disability;

8)  Parents are given the opportunity to express volunteer preferences in a match and those preferences are honored;

9)  I must complete a training prior to being matched with a youth;

10) BBBS is not obligated to match me with a youth;

11) If I am accepted as a Big Brother/Big Sister, I understand my obligation to meet with my Little Brother/Sister regularly and to inform BBBS agency staff as to the status of my match relationship every month. I further agree to accept the supervision of the BBBS staff and discontinue my service if I am requested to do so;

12) I understand Big Brothers Big Sisters has a ZERO TOLERANCE FOR ABUSE and takes all allegations of abuse seriously. BBBS will cooperate fully with the authorities to investigate all cases of alleged abuse.

I have read the above statements and accept them as conditions of volunteering. All parties agree that electronic/digital signatures are the same as handwritten signatures for the purposes of validity, enforceability, and admissibility.

NOTICE

This is to inform you Big Brothers Big Sisters (“BBBS”) may obtain information about you and/or your history related to potential criminal activity. The report from authorized sources may include, among other information, arrest, conviction, and driving record information. BBBS may additionally obtain information concerning your background, character, medical conditions, employment, education, and military experience. Information obtained by BBBS will be used only for the purposes of assessing your suitability to become a volunteer and matching you with a Little Brother or Little Sister.

AUTHORIZATION

I hereby authorize and instruct BBBS to procure a report on me, including a criminal background history, which I understand may include, among other information, arrest, conviction, and driving record information. I also authorize and instruct BBBS to verify my Social Security number and to investigate my background and character in any manner they see fit to evaluate my potential as a Big Brother or Big Sister, including obtaining information from medical providers, employers, educational institutions, military agencies, and any other sources. If I become a volunteer for BBBS, I authorize BBBS to repeat these investigations at any time for as long as I remain a volunteer. I authorize BBBS to disclose relevant information obtained from its investigations to the parent/legal guardian of any child considered as a possible Little Brother or Little Sister to effectively enable the parent to exercise “parental choice” in accepting or denying me as a Big Brother or Big Sister for their child. I authorize and instruct any individual, corporation, and public or private entity having knowledge about me to furnish to BBBS any and all information they may have regarding me. I unconditionally release and hold harmless BBBS and its officers, directors, employees, and agents and any party furnishing information to them pursuant to this authorization from any liability, claims, charges, costs, or causes of action which I or my heirs, executors, or assigns may have as a result of the delivery, disclosure, non-disclosure, or omission of any information. I additionally agree to indemnify BBBS and its officers, directors, employees, and agents for any and all attorney fees, court costs, and other expenses resulting from investigating my background, gathering information concerning me, or verifying personal information about upon the written request of law enforcement agencies. BBBS uses technology tools to enhance personal relationships. Our online platform allows volunteers, youth, parents and BBBS to connect securely using a web application. Furthermore, I understand that BBBS holds the right to deny my participation in the program and, for confidentiality, is not required to disclose reasons for doing so. All parties agree that elecronic/digital signatures are the same as handwritten signatures for the purposes of validity, enforceability, and admissibility. A photocopy of this authorization may be accepted in lieu of the original.