Be a Big - Volunteer Application

Thank You for Defending Potential! 


Congratulations on taking the first step to becoming a Big Brothers Big Sisters mentor! We know you have a lot of questions about what will be expected from you as a “Big”. Being a Big is not complicated nor time consuming; however it does involve a consistent commitment that will result in a positive impact for youth in your community! If you are at least 18 years of age, you are eligible to begin the journey of becoming a Big.


What does it take to be a Big? Ask yourself if you can...


  • Meet your mentee known as “Little Brother or Little Sister” consistently-at least twice a month.
  • Commit to be a mentor to your Little for at least 12 months from match date. Studies show that children achieve the greatest impacts when they have been matched for at least a year.
  • Dedicate the time with your Little to be just the two of you. Your undivided attention is essential in helping a child reach their fullest potential!
  • Contact your assigned Mentoring Relationship Specialist (MRS) each month. Your MRS will be there to guide your match relationship: to answer your questions, offer advice, to help you and your Little have a safe and fun relationship, and to share match activity ideas. Bigs in our programs receive a monthly newsletter with activity ideas and also have access to our Match Activities website.
  • Have your own reliable transportation for meeting with your Little.

As you consider becoming a Big, be aware that significant life changes can negatively impact your ability to consistently spend time with your Little. While none of the events listed below would disqualify you from becoming a Big, we do want you to consider them as they could ultimately affect the quality and length of your match. Looking forward two years, do you anticipate any of the following significant life events?


  • Changing jobs or employment status
  • Marital/family status (marriage, divorce, pregnancy, adoption, caring for parent, etc.)
  • Moving (either within the area or out of town)
  • School status (expecting an especially busy semester, changing schools, graduating)
Remember, being a Big isn't about finding time for your mentee; it is about inviting a young person into the life you are already living. We look forward to partnering with you to further our mission of creating and supporting on-to-one mentoring relationships that ignite the power and promise of youth.
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Additional Information



Previous Experience



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. Please only list references that you have known for at least one year.
Spousal/Familial Reference







Professional Reference






Personal Reference







Volunteer Experience










I understand that:
  1. The references and youth organizations that I have worked for, or been involved with as a volunteer, whose information I have provided may be contacted by telephone or email.
  2.  I am in no way obligated to perform any volunteer services.
  3. The information I provide may be used to conduct a background check, to include a driving records check, criminal background check, and other records where required by local, state, or federal law for volunteers working with youth. If matched, the information I provided may also be used to conduct an annual criminal background and driving records check. Continued involvement will be based on the information discovered.
  4.  Big Brothers Big Sisters of Southwest Michigan has the right to accept or deny program participants and is not obligated to match me with a youth. Big Brothers Big Sisters is not required to provide me with a reason if I am not accepted or matched with a youth.
  5. Background checks will be updated every 3 years while I am still matched with a youth.
  6. As part of the enrollment process, I agree to provide additional personal information to assist Big Brothers Big Sisters of Southwest Michigan in making a recommendation for matching.

Page 4

ACCESS TO CONFIDENTIAL CLIENT & VOLUNTEER RECORDS

In order for Big Brothers Big Sisters of Southwest Michigan to provide a responsible and professional service to clients it is necessary for volunteers, clients and parents or guardians of clients to be asked 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 the situations below, shares information about clients and volunteers only among the agency professional staff.  (Note:  These files are handled by clerical staff, both paid and volunteer.) The right to confidentiality applies not only to written records, but also to video, film, pictures, and use of client or volunteer’s name in agency publications.

 

All records are considered the property of the agency and not the agency worker, clients, or volunteers themselves.  In order to provide a service that is in the best interest of the children served by the program, information from outside sources, including confidential references, must be assessed along with information gained from the clients or volunteers themselves.  Records are, therefore, not available for review by the clients or volunteers.

 

Clients and volunteers will be provided, at the time of application, a copy of this statement on confidentiality along with the exceptions which define the limits of confidentiality.  A client or volunteer shall sign a statement that he/she has read and understands the agency policy on confidentiality and agrees to program participation under the guidelines it sets forth.

 

Limits of Confidentiality


Information from client or volunteer records may be shared with the individuals or organization specified below and under the following conditions:

 

1.    Information will be released to other individuals or organizations only upon presentation of an authorized “consent to release information” form appropriately signed by the client or volunteer.

 

2.   Identifying information (including photographs, videos, etc.) regarding clients and volunteers may be used in agency publications 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 may need 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 purposes(s) stated in the approved action of the Board of Directors.  Known violations of the agency’s 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 identify the person(s) to be authorized to review such 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.

 

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 will be reported to the appropriate authorities.  All workers are responsible for staying abreast of such reporting requirements of their respective 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 himself or herself or to 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.

 

9.   At the time a child or volunteer is considered as a match candidate, information is shared between the prospective match parties. However, the identity of the prospective match mate shall not be revealed at this stage. Names are share with match mates only after the involved parties agree to the match.

 

AGREEMENT TO PROTECT THE CONFIDENTIALITY OF MATCH INFORMATION

I agree to keep information discussed with me regarding a potential (Big Brother, Big Sister, Little Brother, Little Sister) match confidential.  I will not discuss this information with any person other than the assigned professional staff of the Big Brothers Big Sisters’ agency. 

CONSENT TO SHARE MATCHING INFORMATION

I irrevocably consent to any and all uses and displays of my name, image, likeness, appearance, and basic biographical information in, on, or in connection with any advertising, publicity, marketing, or printed or electronic media, of any type, throughout the world at any time by Big Brothers Big Sisters of America, Big Brothers Big Sisters of Southwest Michigan, and any of their affiliates, successors, partners, sponsors, donors, and any entities or persons with whom they conduct any public relations, marketing, or fund raising of any type, without further consent from me or without any royalty, payment, or other compensation to 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.



CONSENT TO USE OF IDENTIFYING INFORMATION IN AGENCY PROMOTIONAL MATERIALS

I give my permission for Big Brothers Big Sisters of Southwest Michigan to use the following information: videos, photos or use of my name.  That information shall be used by the organization identified above solely for the purpose(s) of promotional and recruitment activities.  I understand that no personal history information regarding or identifying me will be used by the agency.  In giving this consent, I release Big Brothers Big Sisters of Southwest Michigan, their nominees, and designees, from any obligation or liability otherwise owed to me in connection with use of the above referenced information.  This consent may be terminated by me at any time, but in the event that I do not exercise my right to terminate this consent, the consent will remain in effect

USE OF ALCOHOL, TOBACCO AND ILLICIT AND LEGAL DRUGS AND SUBSTANCES AGREEMENT

Bigs should not be under the influence or using any substances (including alcohol, illicit drugs, and legal drugs, including marijuana, recreational marijuana, and prescription medications) that could potentially affect judgement, driving, reaction time, or otherwise jeopardize a child’s safety and well-being, while their Little is in the Big’s care. Bigs must not smoke cigarettes, e-cigarettes, or vape when with their Little. Bigs must not expose their Littles to any situations or behaviors that could pose a risk to the Little’s safety. I agree to follow this policy, and understand violating this policy will terminate my match and participation with Big Brothers Big Sisters.

Page 5

PRIVACY POLICY FOR AGENCY USAGE OF VOLUNTEER APPLICANT SOCIAL SECURITY NUMBER

In alignment with the Michigan Social Security Number Privacy Act, Big Brothers Big Sisters of Southwest Michigan assures the following procedures to ensure the privacy of social security numbers obtained from volunteer mentor applicants:

  1. The social security number obtained by completion of this application form will be entered automatically into the secure MatchForce (MF) computer system provided to our agency by Big Brothers Big Sisters of America. Verifying acceptance of this policy below and digitally signing this application form indicates your authorization. Upon entry of the social security number into the MF system, any printed/PDF copy of your application containing the social security number will be blacked out/shredded by a Big Brothers Big Sisters professional staff person. Once entered into the MF system the social security number is encrypted and is not available to any/all persons. The purpose of entering the social security number into the MF system is the following:

  2. To verify that the social security number of the volunteer applicant does not match the social security number of any volunteer applicant previously determined inappropriate for volunteer service in the Big Brothers Big Sisters of America MF data system.  If flagged by the MF system, an agency professional staff person will be alerted and will be required to follow up with the volunteer applicant within five (5) days to corroborate that the applicant is the same individual identified by the system.

  3. Failure to secure the social security number provided by the volunteer applicant within 24 hours of receipt from the volunteer applicant and/or failure to shred/blackout any written copy of the social security number upon entry into the MF system and/or the unlawful disclosure of the social security number will result in immediate dismissal of the offending staff person.

  4. A copy of this policy will be provided to all volunteer applicants upon request for their review.  A social security number cannot be secured without the receipt of the signed release from the volunteer applicant providing the social security number. The signed release of the social security number (absent any written social security number) will be kept in confidential files. 

  5. I, the undersigned, willingly share my social security number with Big Brothers Big Sisters of Southwest Michigan for the purpose of entry into the Big Brothers Big Sisters of America national Agency Information Management System data base for the purpose of ensuring that I have never been determined to be inappropriate for volunteer service to children by a Big Brothers Big Sisters’ agency member of Big Brothers Big Sisters of America network.  I understand that the MF system is fully encrypted and is not available to any/all persons.  I understand that any printed or digital copy of my social security number will be shredded/blacked out upon entry into the MF system

My agreement below verifies that I have read the above policy and that I understand I may request a printed copy of the Social Security Privacy Policy of Big Brothers Big Sisters of Southwest Michigan.


Page 6

GUIDELINES FOR ONLINE SOCIAL NETWORKING

Rationale: Big Brothers Big Sisters of Southwest Michigan recognizes that online social networking (Facebook, Twitter, LinkedIn, blogs, etc.) has become a very popular communications tool and that many of our Big Brothers/Sisters and Little Brothers/Sisters use these websites. Personal use of social networking sites is typically for communications between peers, including friends and family. BBBS wants to reiterate that your relationship with your Little is that of a mentor in addition to a friend. Not all social networking sites are designed to support mentoring relationships.

 

Please proceed thoughtfully when inviting or accepting an invitation from your Little to a social networking site. If you have any doubts, please contact your Match Support Specialist and/or postpone your invitation or acceptance. If you do choose to participate in a social networking site with your Little, you must adhere to the following guidelines regarding any postings related to your match or affiliation with BBBS:

 

     Do not participate in any online communication with/about your Little unless you have discussed this with the parent/guardian and have received their approval. Create a separate group for your Little, his/her parent/guardian and BBBS staff that limits your Little’s access to your general or universal postings.


     Give the parent/guardian and BBBS of Southwest Michigan your website address and, when possible, link your page to the BBBS of Southwest Michigan page on that site so that we can follow along with your postings. We are active on Facebook, Twitter and LinkedIn.


     Never post any pictures of your Little online unless you have the written consent of the child’s parent/guardian. That consent form should be filed with BBBS of Southwest Michigan.


     Never post the last name of your Little, his/her parent/guardian or BBBS of Southwest Michigan staff.


     Never post any contact information for your Little.


     Never post any identifying information about your Little (i.e.: child’s home address, school the child attends, where the parent works, etc).


     Never post anything that could be perceived as judgmental or offensive to your Little or his/her parent/guardian.


     Make sure that your page settings are set to private, so that only people you approve can view your online content. Ensure that BBBS of Southwest Michigan and the parent/guardian are approved if you plan to post content related to your match.


     Honor confidentiality guidelines within your match; be cautious when posting detailed information about conversations with your Little, their parent/guardian or with BBBS staff. Posting generalized information or status updates is typically appropriate, but lengthier postings or blogs containing in-depth information should be approved by the parent/guardian and by BBBS of Southwest Michigan prior to posting.


     Do not post information that can only be accessed through the BBBS of Southwest Michigan monthly activities e-newsletter. These opportunities are meant for current Bigs and Little only, not the general public.


     Be aware of other postings on your page that are not BBBS of Southwest Michigan related or are inappropriate for minors. Know that as a BBBS volunteer you are a role model at all times. Please ensure that all contents are appropriate and kid-friendly, in case your Little or his/her family were to read your social networking page.


     When in doubt about whether or not something is appropriate to post, consult with your Match Support staff person prior to posting.

 

Failure to adhere to these guidelines may result in the termination of your match.


Page 7

FIREARMS/WEAPONS EXPECTATIONS AND ACKNOWLEDGEMENT

While some adults possess weapons for hunting and/or protection purposes, all volunteers with Big Brothers Big Sisters of Southwest Michigan (BBBS) must acknowledge and agree:

1. That any weapons, firearms or ammunition are licensed, permitted, registered, and handled in accordance with all applicable state and federal laws

2. To inform BBBS of the ownership of weapons or the presence of weapons in the home. BBBS staff will discuss weapons ownership during the volunteer’s interview and/or home assessment, and will update that status for the life of the match. For purposes of this policy, “weapons” may include all firearms, zip guns, knives (except for kitchen knives that are not used or intended for use as a weapon or to inflict bodily injury) and explosive devices.

3. A volunteer who owns firearms and stores them at their residence or any other location will lock the weapons in a safe or will install trigger locks whenever a Little is at or near the storage area. Ammunition must be stored separately from the firearm or kept in a locked safe with the firearm.

4. That BBBS will disclose to the parent or guardian of the Little the agency’s weapons policy and the volunteer’s acknowledgement of weapon ownership or the presence of a weapon in the home. The volunteer and the parent/guardian will sign an acknowledgement of the ownership or presence of a weapon, and a copy of the form will be kept in the volunteer’s and the Little’s permanent files.

5. The volunteer will not carry a handgun or weapon on their person or in their vehicle (even if granted a “concealed carry license”) at any time while accompanying the Little or any other child participating in a BBBS activity. Sworn law enforcement officers will follow all local, state and Federal laws, as well as their departmental polices pertaining to the carrying of weapons while in uniform. Officers not in uniform while participating with their Little shall secure their weapon in a locked container not accessible to the Little.

6. To abide by any additional policies or procedures that BBBS may put into effect regarding weapons.
I agree to keep any weapons and ammunition inaccessible to the child assigned to me by BBBS of Southwest Michigan while he/she is in my custody. I further agree to immediately notify BBBS of Southwest Michigan if I or anyone in my household obtains any weapons during the lifetime of the match.

I agree to keep any weapons and ammunition inaccessible to the child assigned to me by BBBS of Southwest Michigan while he/she is in my custody.

I agree to immediately notify BBBS of Southwest Michigan if I or anyone in my household becomes a weapon owner during the lifetime of the match.