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Volunteer Enrollment

By admin - Posted on 15 November 2009

First Name: *

Middle Name: *

Last Name: *

Date of Birth: *

City: *

County: *

State: *

Zip Code: *

Email: *

Home Phone: *

Work Phone: *

Cell Phone: *

Gender: *

Male

Female

Employer:

Ethnicity: *

Do you have a driver's license?: *

Yes

If yes, state of issue and #:

Expiration Date:

References: *

Please type or print information requested for four references (preferably individuals who have seen you interact with children): 1) your current or past employer who has known you for at least 1 year; 2) a co-worker or friend who has known you for at least 2 years; and 3) a close family member (spouse/domestic partner) or a second friend who has known you for at least 3 years; 4) an alternate reference to be called in the event that one of the others may not be reached.

Have you ever applied before (or have been) to be a Big Brother or Big Sister?: *

Yes

What, if any, other youth organizations have you worked for or been involved with as a volunteer?:

If yes, please list contact information Organization:

Signature: *

I understand that:
1)The references I listed may be contacted by mail, telephone, or email;
2)I am in no way obligated to perform any volunteer services;
3)The information I provided may be used to conduct a background check, to include driving records check, criminal background check, and other records where required by local, state, or federal law for volunteers working with youth;
4)BBBS is not obligated to match you with a youth; and,
5)As part of our enrollment processes, we will be asking you to provide additional personal information prior to make any recommendations for assignment.

Date: *

Volunteer Enrollment

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