BBBS Volunteer Application

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Mission: create and support one-to-one mentoring relationships that ignite the power and promise of youth.

Application
This application will take 20-30 minutes to complete. Depending on the program type, you will need the following items to complete the application: 
  • Picture/digital copy of your driver's license or photo ID
  • Picture/digital copy of your driver's insurance
  • Phone number and email address of references: personal, spouse/familial, employer, and any youth-serving organizations you have volunteered or worked with in the last 5 years. 
  • Phone number and date of birth of any adults in the home. 

Non-Discrimination Policy

Our participants come to us with a wide range of personal characteristics and we value our differences. Participant eligibility shall be determined without regard to race, ethnicity, color, religion, national origin, gender, marital status, sexual orientation, gender identity, veteran status, or (dis)ability. 

Basic Information








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Contact Information

If you don't have an email, enter swwabigs.program@gmail.com



If no cell phone, enter home number.





















Employer Information











Additional Information











Previous Experience with BBBS





References 

Please provide at least three 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/Family Reference







Professional Reference






Personal Reference







Volunteer Experience










Volunteer Experience










Volunteer Experience










Enrollment Questionnaire

Prior to your in-person interview, please answer the questions below. Parents of youth in our programs will often ask questions about someone with whom their child will be matched. 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: you will have an opportunity to discuss these questions and your responses more thoroughly during your in-person interview. 
Enrollment Questionnaire




















To ensure safety, our process includes a basic screening of other adults living in a volunteer's home, including a reference call. Please list the full name, other names used (maiden, alias, etc.), and birth date of ALL adults 18 year or older living in your home:








Consent and Releases

Confidentiality Policy 

In order for Big Brothers Big Sisters of Southwest Washington to provide a responsible and professional service to clients, it is necessary for volunteers, clients, parents or guardians to divulge extensive personal information about themselves and their families. The agency 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’s professional staff. The right to confidentiality applies not only to written records but to video, film, photographs, or use of volunteer or client’s name in agency publications. All records are considered the property of the agency and not the agency workers, clients or volunteers themselves. In order to provide a service which is in the best interest of the children served by the program, information from outside sources, including confidential references, shall be assessed along with information gained from the clients or volunteers. Clients and volunteers shall be provided, at the interview, with a copy of this statement on confidentiality along with a list of the expectations, which define the limits of confidentiality. Clients and volunteers shall sign a statement that they have read and understands the agency policy on confidentiality and agrees to the program participation under guidelines it has set forth. 


Limits of Confidentiality

  1. Information may be released to other individuals or organizations only upon the written consent by the client or volunteer.

  2. Identifying information regarding clients and volunteers may be used in agency publications and/or promotional materials if the client or volunteer has given permission.

  3. 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. These outside organizations shall be required to respect the agency policy on confidentiality. Outside parties shall be required to use information only for the purpose stated in the approval action of the Board of Directors. Known violations of agency confidentiality policy will be reported to the supervisor of the individual involved and appropriate disciplinary action shall be requested.

  4. Members of the Board of Directors have access to client files only upon authorization by formal motion of the Board of Directors. The motion shall state who shall be authorized to review records, the specific purpose for such review and the period of time during which access shall be granted. Members shall be required to comply with the agency policies on confidentiality and may use the information only for purposes stated by the approved action of the Board of Directors. Known violations shall be reported to the Board President. A violation of the agency’s confidentiality policy by a Board Member shall constitute adequate cause for removal from office.

  5. Information shall only be provided to law enforcement officials or the courts pursuant to a valid and enforceable subpoena or as required by statute, with exception to number 8 and 9 (see below).

  6. Information shall be provided to an agency’s legal counsel in the event of litigation or potential litigation involving the agency. Such information is considered privileged information, and its confidentiality is protected by law.

  7. State law mandates that suspected child abuse shall be reported to the appropriate authorities (Child Protective Service). All workers are responsible for staying abreast of such reporting requirements of the irrespective jurisdiction and shall always comply with mandated procedures.

  8. If an agency worker receives information indicating that a client or volunteer may be dangerous to themselves or others, necessary steps shall be taken to protect the appropriate party. This may include a medical referral or a report to the local law enforcement authorities or a mental health professional, as appropriate.

  9. It is the position of the agency to not “out” a young person in regards to their gender identity, gender expression or sexual orientation that is confidential to the youth or the parent/guardian. The information will be kept confidential with those whom the child chooses to tell.



Agreement to Protect the Confidentiality of Match Information

I agree to keep the information discussed with me regarding a potential (Big or Little) match confidential. I will not discuss this information with any person other than Big Brothers Big Sisters of Southwest Washington professional staff. I have read and understand that the above document which states the agency policy with respect to confidentiality of client and volunteer records. I agree to program participation under the conditions it sets forth.


Media Release

Virtual Platform

Consent to References and Background Checks
I consent to and understand that:
  1. The references and youth serving-organization 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 and with exceptions noted below.
  8. I understand that incidents of child abuse or neglect, past or present, must 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 timely communication and follow-up with all agency staff.
  12. 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 occurrences. I understand that BBBS staff needs to be fully informed to provide the best guidance or support possible.