Volunteer Application

Employer *

Work Hours *

Can we contact you at work? *

Yes No

If applicable, please list any other addresses you have lived at in past 5 years. *

Occupation *

How long employed? *

Please list any other jobs you have had in the past 5 years. (Employer, City, Job Title, Dates, Reason for Leaving) *

Please list any other people living in your household. Provide Name, age, and relationship to you. *

Driver's license number and State of issue *

Do you have valid insurance that meets or exceeds state required minimum *

Yes No

Driver's license expiration date: *

Highest Level of Education: *

Area of Study: *

Are you a student at this time? If yes, please name school: *

Please list information for AT LEAST THREE references below including:
1. Your spouse or domestic partner (i.e., if you live with a significant other/girlfriend/boyfriend) OR a family member, if you do not have a spouse, partner, or significant other.
2. Current or former employer or co-worker you have known for at least one year, or someone from your school if you are a student; AND
3. A friend or neighbor you have know for at least two year.

In addition to the references above, Big Brothers Big Sisters requires references from ALL YOUTH SERVING ORGANIZATIONS at which you have worked or volunteered in the past.

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, 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;
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.

PLEASE READ THE FOLLOWING CAREFULLY BEFORE SUBMITTING THIS APPLICATION:

I understand that this is an application for a volunteer opportunity and is not a promise or commitment by Big Brothers Big Sisters.

I certify that all information I have provided or will provide to Big Brothers Big Sisters, including this application, is true, correct and complete to the best of my knowledge. I certify that I have and will answer all questions to the best of my ability and that I have not and will not withhold any information that would affect my application for a volunteer position. I understand that information contained on my application will be verified by Big Brothers Big Sisters. I understand that misrepresentations or omissions may be cause for my immediate rejection as an applicant or my termination as a volunteer.

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.

VOLUNTEER APPLICATION

I CONSENT TO AND UNDERSTAND THAT:

PLEASE READ THE FOLLOWING CAREFULLY BEFORE SUBMITTING THIS APPLICATION:

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