Youth Inquiry Form
Parent/Guardian Contact Information
First Name
Nombre
Last Name
Apellido
Email
Correo electrónico (If you do not have an email address, please put swwabigs.program@swwabigs.org)
Mobile Phone
Número del celular
Zip Code
Código postal
County
Please select...
Thurston
Lewis
Mason
Grays Harbor
Pacific
Condado
How did you hear about Big Brothers Big Sisters?
Please select...
Someone I know (word of mouth)
Big Brothers Big Sisters event
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Referral by school, business, or organization
Facebook or social media
Other
What is the parent/guardian's relationship to the youth?
Please select...
Mother
Father
Stepmother
Stepfather
Grandmother
Grandfather
Aunt
Uncle
Relative: Other
Foster Parent
Social Worker/Case Manager
Teacher
Counselor
Clergy
Probation Officer
Non-relative: Other
Self-emancipated Minor
Youth's Information
First Name:
Last Name
Preferred/Nickname:
Date of Birth
(Enter as: MM/DD/YYYY)
Fecha de nacimiento
Gender
Please select...
Female
Male
Trans Female
Trans Male
Genderqueer/Nonbinary
Different Identity
Prefer not to say
Género
How do they identify?
¿Cómo se identifica usted de género?
Pronouns
Please select...
He, Him
She, Her
They, Them
Pronombres
Minimum Eligibility Requirements
Enrolled between the ages of 6 – 16 (17 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:
Yes.
Not yet, but we will soon.
No.
Our Programs
Community-based Program
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.
Site-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:
Community-based
Site-based
Both programs, or I am not sure.
Referral Detail ID (map from dynamic picklist how did you hear about us)
Notifications Email (hidden)
Consent
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.
Yes
No
Contact Information