BBBS Volunteer Application

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

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. 

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. 




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










Policies, Consents & Releases

Confidentiality Policy & Mandatory Reporting 

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.

  10. As a volunteer Big, I understand that personal information about the Little I am matched with, and/or their family, should be held in confidence. I understand that this confidentiality policy does not include my case manager or other Big Brothers Big Sisters agency staff who I might speak with regarding any circumstances of my match.

  11. Information that I share with people I know will be limited to information about the types of activities that my Little and I do together and will not reveal personal information that my Little shares with me. When speaking to people I know about my Little, I will only use their first name and will not identify where my Little lives. 

Mandatory Reporting: I understand that I am a mandatory reporter of child abuse and neglect. If my Little shares any information or I suspect abuse or neglect, I will contact my Match Support Specialist immediately. 


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 as well as Mandatory Reporting. I agree to program participation under the conditions it sets forth.


Media Release

Accident Policy
In the event that a Little is involved in some type of accident involving an injury during a match activity, it is imperative that you notify your Match Support Specialist within 48 hours.

Big Brothers Big Sisters of Southwest Washington has an excess accident policy, which may provide certain benefits. Benefits payable are determined by the following information.
  1. If the injured is currently covered through a separate health insurance policy, that policy will act as primary insurance. The excess accident policy provided by Big Brothers Big Sisters may act as a secondary insurance. This means that the injured will have to submit the claim to their own insurance company prior to submitting a claim to Big Brothers Big Sisters accident insurance. 
  2. If the injured party is not currently covered by any other health insurance policy, the excess accident policy provided by Big Brothers Big Sisters may act as primary insurance.
Consent to References & 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.
  13. I understand that Big Brothers Big Sisters will run a background check every 3 years while I am matched in the program.  
Digital Technology & Social Networking
Choosing to participate with your Little in a Social Networking sites requires prior consent from parents/guardians. Additional limitations are as follows:
  1. Under no circumstances are volunteers allowed to place photo or video materials of the match on media that cannot be set to private.
  2. Do not participate in online communication with the Little without parent’s prior consent. 
  3. Your social media pages must be set to private so that only people you approve can view your online content and photos. You must have agency approval to post match content. 
  4. Never post the names or contact information for your Little, Parents/Guardians or agency staff. 
  5. Never post identifying information about your Little or their family, such as home address, school or work. 
  6. Never post anything that could be perceived as judgmental or offensive to your Little or their parents/guardians. 
  7. Honor confidentiality guidelines within your match. 
  8. Be aware of other postings on your page that may be inappropriate for minors. Know that as a BBBS Volunteer you are a role model at all times. 
  9. When in doubt about whether or not something is appropriate to post, consult with your BBBS staff. 
Firearms & Weapons Policy
Volunteers must disclose any firearms and/or weapons ownership both at enrollment and throughout the life of the match. All volunteers owning firearms and/or weapons must sign an attestation that states any weapons, firearms, and/or ammunition are:
  • Permitted 
  • Licensed 
  • Registered
  • Handled in accordance with all state and federal laws

VOLUNTEER AGREEMENT
While some adults possess weapons for hunting and/or protection purposes, it is the policy of Big Brothers Big Sisters of Southwest Washington that all agency volunteers agree:
  1. To inform Big Brothers Big Sisters of Southwest Washington of the ownership of weapons or the presence of weapons in the home. Big Brothers Big Sisters staff will discuss the ownership of weapons during the volunteer’s interview and/or home assessment, and update the status for the life of the match. For purposes of this policy, weapons will include firearms, handguns, zip guns, archery equipment, knives (except for kitchen knives or small pocket knives not used or intended for use as a weapon or to inflict bodily injury) and explosive devices. 
  2. To ensure that weapons and ammunition are inaccessible to the child assigned to you by Big Brothers Big Sisters of Southwest Washington and to any other child participating in a Big Brothers Big Sisters of Southwest Washington activity, while the child is under your supervision. The means of ensuring the inaccessibility will be discussed during the interview and/or home assessment. 
  3. To adhere to the policy that a volunteer will not carry a concealed handgun at any time while accompanying the child assigned to you by Big Brothers Big Sisters of Southwest Washington or any other child participating in a Big Brothers Big Sisters activity (with the exception of law enforcement officers who are required to carry a weapon at all times and have received prior approval from Big Brothers Big Sisters of Southwest Washington). 
  4. To understand that Big Brothers Big Sisters of Southwest Washington will disclose to the parent or guardian of the child assigned to you by Big Brothers Big Sisters the Agency’s weapon policy and the volunteer’s admission of weapon ownership of the presence of a weapon in the home. The parent/guardian and the volunteer will sign an acknowledgment of the ownership of a weapon and the form will be kept in the child’s permanent file. 
  5. All volunteers agree to abide by any state and federal laws regarding ownership or possession of firearms and/or weapons and ammunition. 
  6. All volunteers agree to abide by any other policy or procedure that Big Brothers Big Sisters of Southwest Washington may put into effect regarding weapons. 
  7. As a volunteer, I understand and agree to abide by the Firearms and Weapons policy of Big Brothers Big Sisters of Southwest Washington. I agree to keep any weapons inaccessible to the child assigned to me by Big Brothers Big Sisters of Southwest Washington while they are in my custody. 
  8.  There is a gun/weapon in my household. The name of the gun owner is __________________. There is not currently a gun/weapon in my household. However, for the duration of my match, if there ever is a gun/weapon in my household, I will abide by the gun storage agreement. I will inform agency staff if I or someone I live with acquires a gun throughout any point in my involvement with the agency. 
  9. As a volunteer Big, I agree to keep all guns/weapons that may be in my home inaccessible to my Little. I will do this by assuring that the following precautions are taken:
         - All guns/weapons in my household will be unloaded, locked-up, and inaccessible to my Little.
         - All guns in my household are registered when legally required.
         - Any bullets or ammunition in my household will be locked-up separately from the guns/ weapons and will be inaccessible to my Little.
         - My Little will have no knowledge of guns/weapons being stored in my home. 

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