BBBS Volunteer Application

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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. 

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Basic Information




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Contact Information

































Employer Information











Additional Information








References and Background Check

Previous Experience










Volunteer Experience











Please provide at least four references below including:
  • Your spouse or domestic partner OR a family member if you do not have a spouse, partner, or significant other.
  • Current or former employee or co-worker you have known for at least one year or someone from your school if you are a student
  • Two friends or neighbors you have known for at least onetwo years
Spousal/Familial Reference







Professional Reference







Minimum 1 year
Personal Reference







Minimum 2 years
Personal Reference







Minimum 2 years
I consent to and understand that:
  1. The references and youth-serving organization(s) I listed may be contacted by mail, telephone, email, or in person;
  2. The information I provided may be used to conduct a background check, to include a search of public domain records, driving records check, juvenile and adult criminal history check (see attached authorization), military records, and other records where required by local, state, or federal law for volunteers working with youth;
  3. I am in no way obligated to perform any volunteer services;
  4. The BBBS agency is not obligated to match me with a youth and may deny my application or close my match at any time, and to protect all participants’ confidentiality, BBBS is not required to disclose reasons for doing so; 
  5. Other BBBS agencies and youth organizations where I have worked or volunteered may be contacted as references;
  6. As part of the enrollment processes, I will be required to provide additional personal information, including completion of an in-person interview;
  7. I understand that the information I provide in the enrollment process will be kept confidential, unless disclosure is required by law.  
  8. I understand that detailed accounts of child abuse or neglect, past or present, will be reported to proper authorities;
  9. I understand that certain relevant information about me will be discussed with the parent/guardian of a child who is a prospective match (this might include demographic information, information relevant to parent/child preferences, and any information relevant to a child’s safety or well-being);  
  10. It is my responsibility to update the agency if any of the information I provide on this application, in my interview, or any other information provided during the enrollment process changes (i.e. address, phone number, auto-insurance, new criminal charges, etc.)
  11. I agree to complete questionnaires throughout my time in the program to evaluate and improve program services;
  12. I agree to timely communication and follow-up with all agency staff as required by the agency.

Pre-Interview Questionnaire

Prior to your in-person interview, please answer the questions below. The information you provide will also help us make a better match for you and assure we can support you during your involvement with our program. Please note that you will have an opportunity to discuss these questions and your responses more thoroughly during your in-person interview.  






Agency Weapons Policy


Big Brothers Big Sisters of Northeastern Pennsylvania requires that all direct service volunteers to disclose ownership of any firearms and/or weapons to BBBS professional program staff at the enrollment stage and throughout the life of the match. The volunteer must attest to the fact that any weapons, firearms or ammunition ownership are licensed, permitted, registered, and handled in accordance with all applicable state and federal laws. During the home visit the BBBS professional program staff will document that weapons and ammunition are kept in a safe and separate location in the home which will be inaccessible to the child while in the volunteer’s care. The ownership of such weapons will be conveyed to the parent of the child at the time of the pre-match interview. In the event the volunteer and child wish to participate in an activity utilizing firearms/weapons such as hunter’s safety classes, target shooting, or hunting these activities must be approved in advance by the parent/guardian and be documented in the program match file. All youth participating in any such activities involving firearms/weapons will be required to participate in the Pennsylvania Hunter’s Safety Classes provided by the Pennsylvania Game Commission.




Please provide the name, age, and relationship to you for anyone else residing in your home.



Release of Information Authorization for Background Check

The information I provided may be used to conduct a background check, to include a search of public domain records, driving records check, juvenile and adult criminal history check, military records, and other records where required by local, state, or federal law for volunteers working with youth.

Required Clearances

Please keep a copy of the following instructions. 

Thank you.

PA State Police Check:

 

https://epatch.state.pa.us


·        Click on New Record Check.

·        Volunteer Only.

·        Click on box at the bottom of page - Check accept.

·        Complete form and follow directions.

·        You can print out and/or save your clearance to a computer. If saved to a computer, then it can also be emailed to your Big Brothers Big Sisters Program Specialist.

·        If “Under Review” comes up, then you may need to continue to check back. Remember to write down the reference number and date of submission so that you can search for your clearance.

Childline Clearance:

 

https://www.compass.state.pa.us/cwis/public/home


·        Welcome to the Child Welfare Portal.

·        If have an Individual Account – Login

·        If don’t have an account, create Individual Account and write down username and password.

o   Once an account is created, a link will be sent to you via email to continue the process.

o   Follow all directions. Be sure to check that you are a "Volunteer Having Contact with Children: Applying for the purpose of volunteering as an adult for an unpaid position as a volunteer with a child-care service, a school or a program, activity or service, as a person responsible for the child's welfare or having direct volunteer contact with children." 

o   You will receive an email when your clearance is ready. You will be required to login to the system, so you will need your username and password.

·     You can print out and/or save your clearance to a computer. If saved to a computer, then it can also be emailed to your Big Brothers Big Sisters Program Specialist.

 

How to Obtain Your Fingerprints :

 

·  Go to https://uenroll.identogo.com/

·  Type in service code 1KG6ZJ (this code is only applicable for volunteers)

·  Schedule Appointment and follow prompts

 

Confidentiality and Digital Platform Policies

In order for the program to provide a reasonable and professional service to clients and volunteers, it is necessary for volunteers, clients, and parents/guardians of clients to be asked to divulge extensive personal information about themselves and their families. The program respects the privacy / confidentiality of the information obtained on clients and volunteers. Information about clients and volunteers is shared only among the agency’s professional staff. These individuals are well aware of the strict confidential nature of the information in the records. Individuals outside of the program’s employ are not allowed access to the files. The right to confidentiality also applies not only to written records but to video, films, pictures, or the use of client or volunteer’s names in program publications as well.


Bigs are to monitor Littles if they are using the internet during a match activity. If a volunteer witnesses their little engaging in inappropriate internet usage they are to direct the little to immediately cease in the engagement of the activity. Volunteers are to notify their program match support specialist as soon as possible. The match support specialist will inform their immediate supervisor, and the parent will be informed of the incident. Big Brothers Big Sisters Policy and Procedure Manual 76 Description of match activities on the Big’s social media pages such Facebook, etc. should be appropriate and carried out with the written approval of the Little and the Little’s parent/guardian on the Agency Public Relations Release form. Big Brothers Big Sisters of America recommends that Bigs should not “friend” Littles on social media (Facebook, Twitter, etc.) Based on this statement, Big Brothers Big Sisters of NEPA encourages following this guideline. However, if social media is to be used by the match participants then signed permission must be documented, with the signatures of the Big, Little, and Little’s parent/guardian and be kept in the Little’s permanent case file. Without this signed release, social media communications should not be used.


Virtual Platform


Media Consent and Release

I irrevocably consent to any and all uses and displays of my name, image, likeness, appearance, basic biographical information, audio/video recordings, writings, artwork, and the like, in original form or in modified form, in whole or in part, in, on, or in connection with merchandise, advertising, publicity, marketing, fundraising, and the like, in printed or electronic media, of any type, throughout the world at any time by Big Brothers Big Sisters of America and BBBS of Northeastern Pennsylvania in their sole discretion, and by any of their affiliates, successors, partners, sponsors, donors, any entities or persons with whom they conduct any public relations, marketing, or fund raising of any type, and any other authorized third parties, without further consent from me, without any royalty, payment, or other compensation to me, and with the release and waiver of any claims, actions, damages, losses, costs, expenses and liability of any kind arising from any such use (the “Released Material”).
In consideration of the mutual promises made herein, and for other good and valuable consideration, the receipt and sufficiency of which I hereby acknowledge, I hereby grant to BBBSA and its affiliates the right to use the Released Material as BBBSA and/or its affiliates may desire, in all media now existing or hereafter created and in all variations and forms including, but not limited to, internal or external publications or productions, informational or recruitment materials, marketing materials, fundraising materials, televised photography and/or recordings, advertisements, Public Service Announcements, and/or online and social media sites. The use of this information shall be at the sole discretion of BBBSA and/or its affiliates.

I further grant to BBBSA and its affiliates the absolute right to use the Released Material in whole or in part, alone or in conjunction with any other image, name, writings or reproduction, in color or otherwise, for art, advertising, business, trade, or any other lawful purpose whatsoever, in perpetuity throughout the world.

I understand and agree that all materials created by BBBSA and/or its affiliates that use the Released Materials are the property of and are owned by BBBSA, and that I cannot authorize their use by any other party.  I further understand that BBBSA may authorize their use by a third party. I hereby irrevocably transfer and assign to BBBSA my entire right, title and interest, if any, in and to the Released Materials and all copyrights in the Released Materials arising in any jurisdiction throughout the world, including the right to register and sue to enforce such copyrights against infringers.

I acknowledge and agree that I have no right to review or approve the Released Materials before they are used by BBBSA and/or its affiliates, and that BBBSA has no liability to me for any editing or alteration of the Released Materials or for any distortion or other effects resulting from BBBSA’s and/or its affiliates’ editing, alteration or use of the Released Materials.  BBBSA has no obligation to use the Released Materials or to exercise any rights given by this Consent and Release Form.

I hereby release BBBSA and its affiliates, employees, and agents, as well as any partner companies, from all claims, demands or liabilities and related financial costs that I may now or hereafter have arising in connection with BBBSA’s exercise of the rights hereby granted, and/or with the appearance or the Released Materials in any publication or production. These include, without limitation, claims for compensation, defamation, or invasion of privacy, or other infringements or violations of personal or property rights of any sort whatsoever.

Application Acknowledgement

I understand that this is an application for a volunteer opportunity and is not a promise or commitment by Big Brothers Big Sisters.

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 application for a volunteer position. I understand that information contained in my application will be verified by Big Brothers Big Sisters. I understand that misrepresentations or omissions may be cause for my immediate rejection as an applicant or my termination as a volunteer.

At any time while involved with the Big Brothers Big Sisters program, I agree to immediately inform my Big Brothers Big Sisters contact person of any and all infractions, violations, charges, and convictions related to any civil, domestic, or criminal matters.  I understand that BBBS staff needs to be fully informed to provide the best guidance or support possible.