BBSVC High School Mentor Application

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High School Mentor Program Checklist

As a BBSVC High School Mentor applicant, you must complete or provide the following:

    • DUE SEPTEMBER 7, 2020: Volunteer Application, Photo Release, Preliminary Agreement, and personal info forms
    • DUE SEPTEMBER 7, 2020: Reference Letter provided by an adult other than a parent/guardian or BBSVC staff member
    • Attend the BBSVC High School Mentor ORIENTATION
    • Attend a BBSVC High School Mentor INTERVIEW
    • Attend the BBSVC High School Mentor TRAINING
    • Understand that you are committing to volunteer for the full school year

Program will transition into optional, in-person meetups when BBSVC has permission to do so from the county, school district, and school sites.

PLEASE NOTE: Information collected in this application will be kept confidential and will only be used for BBSVC mentoring program and support purposes.
Hidden Fields
To look up the owner's email for notifications
For notifications
Volunteer Mentor Application: For the STUDENT to fill out
Enter a date in the following format: mm/dd/yyyy
This is the year the youth will graduate.
Press CTRL while choosing to select multiple
Physical Address

Volunteer Agreements

Volunteer Mentor Personal Information Form


As a mentor with Big Brothers Big Sisters of Ventura County, I agree to abide by the following rules, expectations, and policies at all times - while with my Little, while representing BBSVC, and in the community:

I agree...
  • To volunteer or participate for the entire school year.
  • That I must always remember to be a positive role model.
  • That the success of my mentoring match is measured by how well I've established a one-to-one friendship with my Big or Little.
  • That I am participating to assist myself and others in setting goals, and to encourage one another to reach them.
  • To abide by all school rules of the campus I am on.
  • To never leave my own Little alone or unattended with any other person other than a BBSVC staffperson.
  • That I will not spend time socializing with other mentors or my own friends while I am signed in and working with my Big, Little, or other program students.
  • That I will not use my cell phone while I am signed in and working with my Big, Little, or other program students.
  • That I will not photograph or record video of my Big or Little, or share anything about them on social media without permission from BBSVC staff.
  • To dress appropriately and respect the school dress code of the campus I am on.
  • To wear my name tag and BBSVC shirt on-site at all times.
  • To always let my Little and BBSVC staff know when I am leaving or if I am not going to participate in program that day.
  • To not bring gifts or food to my Little, or eat in front of them, unless I get permission from BBSVC staff first.
  • To keep confidential all personal information I might learn about the Little and their family.
  • To not exchange phone numbers or email addresses with my Little, nor use social media with my Little.
  • To not arrange to see my Little outside of the program.
  • To respond to calls, emails, texts, and letters from BBSVC staff in a timely manner (but not during class).
  • To let BBSVC staff know immediately if a problem arises between my Little and me, or if I have a concern.
  • To notify BBSVC staff within 3 school days if my place of residence or phone number changes.
  • To notify my parent/guardian of my volunteer schedule, site, and responsibilities, and any field trip opportunities.
  • To take part in all training and evaluations required by BBSVC staff.
  • To adhere to one week probation from the program if I break this code of conduct.

Parent/Guardian Form: for PARENT/GUARDIAN to fill out

Guardian Information
Type NA if unemployed
Family Information
Existing Household Members
Please choose this child's relationship to the following people:

Parent/Guardian Agreement
To the best of my knowledge, the information provided is true and correct.

I have read and understand the statements provided in this form. As the parent/legal guardian of the student named on this form, I give my permission for them to participate in the BBSVC High School Mentor Program, either in-person or virtually. To plan for the academic needs of my student, I give permission for BBSVC staff to obtain any pertinent information regarding their school status from their teacher.

Medical Information

Emergency Contact

Transportation Permission Slip

I understand that my student has signed up to participate in the BBSVC High School Mentor Program, and may benefit from transportation provided by BBSVC. If my student utilizes transportation provided by BBSVC staff: I agree that in case of an accident or injury to my student to hold blameless, and to waive all claims against BBSVC, its officials, staff, or anyone who it may hire or appoint to provide transport or supervise activities. I understand that BBSVC and its personnel are not responsible for personal injury or loss of property.

FERPA Waiver

This waiver allows BBSVC to support your student and their goals by collecting information associated with their educational progress and individual needs:

I willingly waive my rights protected by the Family Education Rights & Privacy Act (FERPA). I willingly give my consent for Big Brothers Big Sisters of Ventura County (BBSVC) to obtain the followiing school records from the Office of the Registrar:

Class Schedule
Immunization Record

This is a permanent release unless I cancel the request in writing for BBSVC.

Photography and Video Release Form

This waiver allows BBSVC to use photographs or video that may be taken of your student during their participation with the High School Mentor Program:

I, the undersigned, certify that I am the legal parent or guardian of , (name of “Little” or minor “Big”), a minor child (hereafter, the “Minor Child”), and that I have full authority to execute this Consent and Release Form.

I understand that Big Brothers Big Sisters of Ventura County ("BBSVC") and/or its affiliates are seeking to use my or the Minor Child’s image and/or likeness, with or without the use of their name, biographical information, personal characteristics, quotations, writings, information contained in writings, and/or audio or video recordings of me or the Minor Child, whether made through BBSVC or elsewhere (the “Released Material”) for or in BBSVC and/or affiliate publications or productions. In consideration of the mutual promises made herein, and for other good and valuable consideration, the receipt and sufficiency of which I hereby acknowledge, I hereby grant to BBSVC and its affiliates the right to use the Released Material as BBSVC and/or its affiliates may desire, in all media now existing or hereafter created and in all variations and forms including, but not limited to, internal or external publications or productions, informational or recruitment materials, marketing materials, fundraising materials, televised photography and/or recordings, advertisements, Public Service Announcements, and/or online and social media sites.

The use of this information shall be at the sole discretion of BBSVC and/or its affiliates. I further grant to BBSVC and its affiliates the absolute right to use the Released Material in whole or in part, alone or in conjunction with any other image, name, writings or reproduction, in color or otherwise, for art, advertising, business, trade, or any other lawful purpose whatsoever, in perpetuity throughout the world. I understand and agree that all materials created by BBSVC and/or its affiliates that use the Released Materials are the property of and are owned by BBSVC, and that I cannot authorize their use by any other party. I further understand that BBSVC may authorize their use by a third party. I hereby irrevocably transfer and assign to BBSVC my entire right, title and interest, if any, in and to the Released Materials and all copyrights in the Released Materials arising in any jurisdiction throughout the world, including the right to register and sue to enforce such copyrights against infringers.

I acknowledge and agree that I have no right to review or approve the Released Materials before they are used by BBSVC and/or its affiliates, and that BBSVC has no liability to me for any editing or alteration of the Released Materials or for any distortion or other effects resulting from BBSVC’s and/or its affiliates’ editing, alteration or use of the Released Materials. BBSVC has no obligation to use the Released Materials or to exercise any rights given by this Consent and Release Form.

I hereby release BBSVC and its affiliates, employees, agents, and any partner companies, from all claims, demands or liabilities and related financial costs that I or the Minor Child may now or hereafter have arising in connection with BBSVC’s exercise of the rights hereby granted, and/or with the appearance or the Released Materials in any publication or production. These include, without limitation, claims for compensation, defamation, or invasion of privacy, or other infringements or violations of personal or property rights of any sort whatsoever.