Youth Inquiry Form
Parent/Guardian Contact Information
Correo electrónico (If you do not have an email address, please put email@example.com)
Número del celular
How did you hear about Big Brothers Big Sisters?
Someone I know (word of mouth)
Big Brothers Big Sisters event
Referral by school, business, or organization
Facebook or social media
What is the parent/guardian's relationship to the youth?
Social Worker/Case Manager
Date of Birth
(Enter as: MM/DD/YYYY)
Fecha de nacimiento
Prefer not to say
How do they identify?
¿Cómo se identifica usted de género?
Minimum Eligibility Requirements
Enrolled between the ages of 6 – 14 (16 f
or female-identifying youth).
Live in Thurston, Lewis, Mason, Grays Harbor, or Pacific Counties.
Be willing to make a minimum one-year commitment.
Parent/guardian must be willing to maintain monthly contact with BBBS staff for the duration of the match.
Youth must personally want a mentor involved in their life.
Youth must live with parent/guardian or in a long-term foster care placement without plans of moving for the first 12 months of the match.
My youth meets these eligibility requirements:
Not yet, but we will soon.
Littles meet up with their Big 2-4 times per month when they both have the time.
Parent/guardians arrange and approve all outings.
The match can explore common interests out in the community such as attending a sporting event, going for a hike, or cooking together! It's up to you as a guardian, the Big, and the Little. Matches are also invited to match activities including sporting events, attractions, and gaming entertainment.
We are interested in the Community-based program:
Littles meet their Big at one of our partner sites for one hour per week (or at least 2 times per month) during their lunch break or after school.
Littles will meet with the same Big each week and can spend time eating lunch, participating in structured activities, playing games, working on homework, or hanging out on the playground.
This program is available only at select sites.
We are interested in the Site-based program:
Referral Detail ID (map from dynamic picklist how did you hear about us)
Notifications Email (hidden)
I understand that submitting this form indicates that I am interested in more information about enrolling my youth in the BBBS program. I consent to BBBS staff reaching out to me via the contact information I have provided.
I understand that this is not an application. I know I will be required to submit a full application before my youth will be put on the waitlist.