High School Big Application

Nationally Recognized As A Pinnacle Agency

Thank you for your interest in becoming a Big Brother or Big Sister. Along with this application, you will need to submit a copy of your driver's license. All applications will be given equal consideration regardless of race, age, sex, disability, marital status, sexual orientation, religion, or national origin.

Contact Information

*First Name

Middle Name

*Last Name

Personal Pronouns

Gender/Gender Identity

Preferred Name

Date of Birth

Home Phone

Work Phone

*Cell Phone

Is it okay to text you?

*Home Address

*City

School

*State

*Zip

*Personal E-mail

Work E-mail

How do you prefer to be contacted?

School ID#

Current grade level

Period and time available for Lunch Buddies

*Parent/Guardian Name

*Parent/Guardian Phone Number

If applicable, maiden name

Nationality/Country of Origin

Do you have a current and valid driver's license?

State of issue and #

Expiration date

Do you have a vehicle?

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

References

*Reference 1 - Relationship (Must Be Spouse or Family Member):

*Reference 1 - Name:

*Reference 1 - Phone:

*Reference 1 - Email:

*Reference 2 - Relationship (Must Be Teacher or Counselor):

*Reference 2 - Name:

*Reference 2 - Phone:

*Reference 2 - Email:

*Reference 3 - Relationship (Must Be Personal):

*Reference 3 - Name:

*Reference 3 - Phone:

*Reference 3 - Email:

General Information

Have you previously applied to be or served as a Big Brother or Big Sister here or anywhere else?

Have you ever been involved with Big Brothers Big Sisters in a capacity other than a Big?

Have you ever been involved with or volunteered for another youth organization?

Have you ever been denied acceptance as a Big Brother or Big Sister?

Have you ever been convicted of a crime other than a minor traffic violation?

How did you hear about us?

School-Based Volunteer Pre-Interview Questionnaire

Site Location Preference

List Days/Times when you are available to volunteer

What experience do you have working with youth?

Would you describe yourself as a person who enjoysWatching events or activitiesActively participating in activitiesBoth

Do you have transportation to the selected site?YesNo

Will you be carpooling?YesNo

With whom?

Do you anticipate any significant life changes over the next year or have you had any in the past year? (Any plans to make a school, job, career or life change)YesNo

Are you experiencing any physical/mental health problems/issues that could affect the match?YesNo

In identifying a youth for you to work with, are there any special considerations you want us to know about?YesNo

Are there any situations (ie: ADHD, history of abuse) involving a child that you would not feel comfortable working with'?YesNo

Have you ever been charged or convicted of a crime?YesNo

Additional Information

How many hours per week are you available to spend with a Little?

Do you have a preference for a Big Brother or Big Sister match? If yes, please explain.

Please list any hobbies, interests, or special skills that you have that you would like us to consider when matching you with a Little

Please list three personal references (not relatives) with complete contact information

Contact Us

Business Hours

Day of Week	Start Time	Start Time AM/PM	Start/End Time Separator	End Time	End Time AM/PM
Monday	8:00	AM	-	4:00	PM
Tuesday	8:00	AM	-	4:00	PM
Wednesday	8:00	AM	-	4:00	PM
Thursday	8:00	AM	-	4:00	PM