Become A Big - Volunteer Application

Thank you for your interest in becoming a Big!

The mission of Big Brothers Big Sisters is to provide children facing adversity with strong and enduring, professionally supported one-to-one mentoring relationships that change their lives for the better, forever. Big Brothers Big Sisters focuses on one-to-one mentoring relationships which help youth in the program build their self-esteem, foster stronger relationships, have higher aspirations, and set and achieve goals.

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

Meet consistently with your Little for at least an hour twice a month.
Commit to being a Big to your Little for at least 12 months. The greatest impacts are made when a child has been matched with their mentor for at least a year.
Dedicate the time you carve out of your schedule for outings to be just for you and your Little. One-on-one time is essential to helping your Little achieve their full potential!!
Maintain contact with BBBS each month. We will be there to support 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.
Have your own reliable transportation for meeting with your Little.

The youth and volunteer generally see each other 2-4 times each month for 1-5 hours. Bigs and the Little’s caregiver work together to schedule a good time for outings. If Bigs are volunteering for the site-based program, BBBS can help coordinate a consistent schedule for match meetings with the youth's school or after school program.

Community-Based matches do ordinary, everyday things! Bigs and Littles may have interests in common, such as fishing, cooking, baking, a love of arts and crafts, or maybe the Big has a special talent that the Little would like to learn about! They may try new things together, attend special events, or even volunteer together. A Community-Based Big can pick their Little up just to hang out, run errands, grab a bite to eat, or go for yummy ice cream treat! Site-Based matches usually play board games, do homework, make art together or just hang out, talk and get to know each other. The ideas are endless! The agency also offers occasional group activities, such as ice skating, picnics, roller skating, and more! As a Big, you are volunteering your time to be a friend to a child. Just by consistently showing up, you make a huge impact on your Little!

Overall, the agency is funded by private donations, grants and fundraising activities. The agency is a not-for-profit organization and contributions are tax deductible. Participants are encouraged to help with fundraising and promotional activities.

Click next and fill out the application and initial paperwork. BBBS will call you to schedule an Information Session where you can ask any questions you may have and have a deeper discussion about the next steps!

Have a picture of your driver's license and proof of insurance handy. You'll need to upload that for the application.

Basic Information

First Name

Middle Name

Last Name

Preferred Name

Maiden Name

Date of Birth

Gender

Please Specify Gender

Pronouns

Please Specify Pronouns

Sexual Orientation

Race/Ethnicity

Nationality

Preferred Language

Relationship Status

Military Status

Highest Level of Education

What program are you interested in?

Do you have a driver's license or state ID?

ID Expiration

Driver's License/ID Number

ID State

Upload a copy of your license/ID.

Auto Insurance Carrier

Upload a copy of your auto insurance.

Insurance Effective Date

Insurance Policy Duration

Contact Information

Personal Email

Work Email

Preferred Email

Phone

Preferred Contact Method

Best Time to Contact You

Emergency Contact Name

Emergency Contact Phone

Emergency Contact Relationship

Address

Street Address

City

State

Zip Code

County

*Please use St. Joe for Indiana and St. Joseph for Michigan.

Other states of residence in the past five years.

Check here if you have another address (dorm, etc).

Other Street Address

Other City

Other State

Other Zip Code

Student/Employment Information

Are you a student or employee?

Employer

Occupation

Employer Street Address

Employer City

Employer State

Employer Zip Code

Employment Length (Years)

Employment Length (Months)

Work Schedule

School

Education Years Completed

School Schedule

Additional Information

Which county do you want to volunteer in? (Use CTRL click to multi-select all that apply.)

How did you hear about us?

Have you previously applied to be a Big here or anywhere else?

Where?

When?

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.

Familial/Spouse Reference

First Name

Last Name

Email

Phone

Relationship To You

Years Known

Professional Reference

First Name

Last Name

Email

Phone

Relationship To You

Years Known

Personal Reference

First Name

Last Name

Email

Phone

Relationship To You

Years Known

Volunteer Experience

Have you held a volunteer or paid position where you worked with children in the last five years? (for example counselor at a camp, babysitting, nannying, coaching, etc.)

Organization Name

Location

Start Date

End Date

Direct Supervisor First Name

Direct Supervisor Last Name

Email

Phone

Years Known

Reason for Leaving

I understand that:

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. I am in no way obligated to perform any volunteer services.

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. I agree to disclose updates on any criminal charges or driving offenses immediately to BBBS.

Big Brothers Big Sisters Southern Lake Michigan Region 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.

Background checks will be updated every 3 years while I am still matched with a youth.

As part of the enrollment process, I agree to provide additional personal information to assist Big Brothers Big Sisters Southern Lake Michigan Region in making a recommendation for matching.

I accept these terms and conditions.

Weapons & Firearms Policy

While some adults possess weapons for hunting and/or protection purposes, it is the policy of Big Brothers Big Sisters (BBBS) that all agency volunteers agree:

1. To inform BBBS of the ownership of weapons or the presence of weapons in the home. BBBS staff will discuss the ownership of weapons during the volunteer’s interview and/or home assessment, and 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.

2. To ensure that weapons and ammunition are inaccessible to the child assigned to you by BBBS and to any other child participating in a BBBS activity, while the child is under your supervision. A Volunteer who owns firearms and stores them at his/her residence or any other location will lock the weapons in a safe or install trigger locks whenever a Little is at or near the storage area. Ammunition must be stored separately from firearm or it can be locked in a safe with the firearm.

3. To adhere to the policy that a volunteer will not carry a handgun or weapon (even if volunteer has a “concealed carry license”) at any time while accompanying the child assigned to you by BBBS or accompanying any other child participating in a BBBS activity (with the exception of law enforcement officers who are required to carry a weapon at all times and have received prior approval from BBBS).

4. To understand that BBBS will disclose to the parent or guardian of the child assigned to you by BBBS the agency’s weapons policy and the volunteer’s admission of weapon ownership or the presence of a weapon in the home. The parent/guardian and the volunteer will sign an acknowledgement of the ownership of a weapon and the form will be kept in the child’s permanent file.

5. To obtain written permission from the child’s parent/guardian and from BBBS before engaging in any activity in which a weapon may be used with the child assigned to you by BBBS or with any other child participating in BBBS activities.

6. To abide by any other policy or procedure that BBBS may put into effect regarding weapons.

I understand and agree to the weapons and firearms policy.

Please select all that apply.

I DO OWN A WEAPON and said weapons are licensed, permitted, registered, and handled in accordance with all applicable Indiana Laws and federal laws.I DO NOT OWN A WEAPON.

Please select all that apply.

A WEAPON IS PRESENT in my household.A WEAPON IS NOT PRESENT in my household.

Video/Photography & Social Media Release

I hereby grant Big Brothers Big Sisters Southern Lake Michigan Region the irrevocable right and permission to use photographs and/or video recordings of me on BBBS and other websites and in publications, promotional flyers, educational materials, derivative works, or for any other similar purpose without compensation to me. I understand and agree that such photographs and/or video recordings of me may be placed on the Internet. I also understand and agree that I may be identified by first name only in printed, Internet or broadcast information that might accompany the photographs and/or video recordings of me. I waive the right to approve the final product. I agree that all such portraits, pictures, photographs, video and audio recordings, and any reproductions thereof, and all plates, negatives, recording tape and digital files are and shall remain the property of Big Brothers Big Sisters Southern Lake Michigan Region. I hereby release, acquit and forever discharge Big Brothers Big Sisters Southern Lake Michigan Region, its current and former trustees, agents, officers and employees of the above-named entities from any and all claims, demands, rights, promises, damages and liabilities arising out of or in connection with the use or distribution of said photographs and/or video recordings, including but not limited to any claims for invasion of privacy, appropriation of likeness or defamation.I hereby warrant that I am eighteen (18) years old or more and competent to contract in my own name or, if I am less than eighteen years old, that my parent or guardian has signed this release form below. This release is binding on me and my heirs, assigns and personal representatives.I understand that I can revoke this right in writing at any time and if I do not revoke this right, this release shall remain valid.

his release is to protect myself, the youth, parents/legal guardian, the promoter/advertiser and Big Brothers Big Sisters Southern Lake Michigan Region from any legal matters brought forth by parties involved. A copy of this policy can be provided upon request.

Please choose.

I consent to usage of video.I consent to usage of photos.I consent to being part of social media.I do not consent - please do not use photos, videos, or posting on social media.

Social Media Policy

Purpose & Scope of Policy

When used appropriately, BBBS believes that social media is a tool that can be utilized in the communication and strengthening of the bond between the Big, Little, Parent and agency. Social Media includes, but is not limited to Facebook, Twitter, Pinterest, Instagram, Myspace, blogs, buzzfeeds, snapchats and other sites.

As a condition of being a Volunteer Big, volunteer Bigs must read, understand, and agree to abide by this Policy. Failure to adhere to this Policy may result in the early termination of a match relationship.

Affiliate Position on Use of Social Media

BBBS encourages volunteer Bigs to using age appropriate Social Media with Littles, Little’s parent/guardian(s), family members in accordance with the guidelines of this policy.

BBBS requires volunteer Bigs and parent/legal guardian(s) of the Little to actively opt-in or opt-out of participation in social media with regards to the match relationship. In order for the Big to post any picture or name, the primary parent/guardian’s consent must be given. Otherwise, only generic information may be used.

If either party does not consent, the other party may not specifically identify or communicate with said party within the context of social media.

If a Parent/Guardian or Big chooses to not opt-in and sign the Photo/Social Media Release form, examples of prohibited activities include:

-Posting photos of person

-Tagging or Listing of name in a post or photo

-Checking in at particular locations, specifically identifying the Big or Little

Overall Monitoring of Safety, Confidentiality & Privacy

If a Big or Parent/Guardian chooses to use social media within the context of the match relationship, the Big and Parent/Guardian shall agree to the following:

-Terms of use of specific Social Media sites

Upon opting in, each Volunteer Big/Parent/Guardian will certify that s/he has reviewed the terms of use/service and any applicable privacy policy and /or provisions on minors of the Social Media sites that they intend on using with the Littles.

-Privacy settings

Upon opting in, each volunteer Big, if using Social Media with their Little, has customized their Social Media settings to ensure that no personal information is viewed by the general public, in order to protect the Little from searches by or contact from the general public.

-Monitoring for legal, respectful, appropriate content

Upon opting in, each volunteer Big will monitor their Social Media sites to ensure that all posts and posted materials, whether by the volunteer Big or a third party, are respectful, legal, and appropriate. If a party observes any social media interactions that are disrespectful, illegal, or inappropriate material, the other party is instructed to contact MSS immediately.

-Enhanced restrictions for access to site by Little

Upon opting in, each volunteer Big will use Social media privacy controls and settings to restrict accessibility of the Little to age appropriate content, including wall comments.

-Process for reporting misuse, endangerment

Upon opting in, each volunteer Big understands what to do in the case of viewing any information on the Little’s Social Media site that may endanger that Little’s health, safety, and welfare. Volunteer Big should contact MSS immediately and understand that it is required by Indiana State law to report child abuse to law enforcement personnel.

-Confidentiality / Privacy of Little/Little’s family

Upon opting in, volunteer Bigs should not disclose personal information about the Little or their family. Information might include but are not limited to: address, phone number, first and last names, private locations, occupations, other members of the family or problems and concerns that would required match support conversations. Volunteer Bigs are permitted to share match activities, success stories and positive feedback about the program.

-Access to information and reposting from the affiliate’s site

Whether opting in or opting out, volunteer Bigs are not allowed to repost content from any “Bigs Only” pages on BBBS’s Facebook page or private section on the BBBS website, particularly if the content not available to the general public. However, volunteer Bigs are permitted and encouraged to share and repost information from the BBBS’s public Facebook page and website, especially promoting fundraising and recruitment efforts of the agency.

-Promotion and attribution

When a participant posts something regarding the agency, BBBS requests that participants consider the impact (positive or negative) of such posts. Volunteer Bigs should represent that their opinion(s), belief(s) and statements are personal, and do not represent the opinion(s), belief(s) or statements of BBBS.

Compliance

- Investigation non-compliance

BBBS will not actively monitor the volunteer Bigs Social media sites; however, if there is a complaint or inquiry, or BBBS becomes aware of a potential violation of this policy or any other, then BBBS has the right to access the volunteer Big’s Social Media site for compliance purposes.

-Consequences of non-compliance

Based on the severity of non-compliance, consequences may range from putting the match on hold to termination of match relationship. If at any time BBBS observes anything that it suspects might put the child’s safety at risk, the agency will exhaust all methods to protect the safety of the child.

Process for distribution of Social Media Policy

This policy will be distributed to volunteer Bigs and Parent/Guardians at the time of Enrollment.

I understand and agree to abide by the Social Media Policy and all the policies contained therein. BBBS Southern Lake Michigan Region will not actively monitor the social media sites; however, if there is a complaint or inquiry, or BBBS becomes aware of a potential violation of this policy or any other, then BBBS Southern Lake Michigan Region has the right to access the social media site for compliance purposes.

Confidentiality Agreement

I thoroughly understand the need for confidentiality and I understand and acknowledge the following:

1. All information that I may encounter about any child, child’s family, Big Brother/Big Sister, the Big Brother’s/Big Sister’s family or anything else of a confidential nature about any child or volunteer in any way connected with Big Brothers Big Sisters WILL BE HELD CONFIDENTIAL.

2. Any information that reveals or tends to reveal the identity of any person who is the subject of the record WILL BE HELD CONFIDENTIAL.

3. The identity of any person who contributes information to the subject record WILL BE HELD CONFIDENTIAL.

4. The results of any inquiry into school records or medical records of any description WILL BE HELD CONFIDENTIAL.

5. I will NOT discuss any information that I am privileged to receive with any other person without the verbal or written permission of the program staff.

6. I will only release prior approved information to the individual to whom I have been given permission to release the information.

7. I agree to hold all related information confidential and, except as I may be legally required, I will NOT disclose or release it to any individual or corporation at anytime.

8. I understand that Big Brothers Big Sisters agrees to hold all related information confidential and, except as we may be legally required, we will NOT disclose or release it to any individual or corporation at anytime.

I have read and agree to the above Confidentiality Agreement.

Participation Agreement

UPON SUBMITTING THIS APPLICATION, 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 have provided may be used to conduct background checks, 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 (this might include demographic information, information relevant to parent/child preferences, and any information relevant to a child’s safety or well-being).

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.

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

I certify that all information I have provided or will provide to Big Brothers Big Sisters Southern Lake Michigan Region, 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 Southern Lake Michigan Region. I understand that misrepresentations or omissions may be cause for my immediate rejection as an applicant or my termination as a volunteer.

I fully understand my responsibilities and requirements in the match relationship and as a participant of the Big Brothers Big Sisters program. I agree to comply, to the best of my ability, with the Guidelines and Ground Rules set forth.

Social Security Agreement

The social security number obtained after completion of this application form will be entered automatically into the secure Match Force (MF) computer system provided to our agency by Big Brothers Big Sisters of America. The purpose of entering the social security number into the MF system is the following:

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. A copy of this consent 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.

Upon signing below, I willingly share my social security number with Big Brothers Big Sisters Southern Lake Michigan Region for the purpose of entry into the Big Brothers Big Sisters of America national Agency Information Management System data base in order to ensure 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.

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.