Our Programs Which program are you applying for? Please select... Community based School based Non-Discrimination Policy
Our participants come to us with a wide range of personal characteristics. We believe that participant eligibility shall be determined without regard to race, color, religion, national origin, gender, marital status, sexual orientation, gender identity, veteran status, or disability. Basic Information Name (Required)
Gender Please select.... Male Female Trans Male Trans Female Genderqueer/Nonbinary Different Identity Prefer not to say Personal Pronouns Please select.... He, Him She, Her They, Them Different pronouns Race/Ethnicity (hold CTL/CMD to select multiple) American Indian or Alaska Native Asian - Chinese Asian - Filipino Asian - Indian Asian - Japanese Asian - Korean Asian - Other Asian - Vietnamese Black or African American Hispanic - Cuban "Hispanic - Mexican, Mexican American, Chicano" Hispanic - Other Latinx or Spanish origin Hispanic - Puerto Rican Middle Eastern or North African Pacific Islander - Chamorro Pacific Islander - Native Hawaiian Pacific Islander - Other Pacific Islander - Samoan White or Caucasian Other Prefer not to say Nationality Algerian American Argentinian British Burmese Cambodian Canadian Chilean Chinese Colombian Congolese Cuban Dominican Egyptian El Salvadorian Ethiopian Fijian Filipino Gambian Ghanaian Guamanian or Chamorro Guatemalan Guinean Hmong Indian Indonesian Japanese Karen Kenyan Korean Laotian Liberian Libyan Malaysian Mexican Micronesian Moroccan Namibian Nigerian Oromo Other African Other Asian Other Central American Other South American Pakistani Polynesian Prefer not to answer Puerto Rican Rwandan Samoan Somali South African Spaniard Sudanese Taiwanese Thai Ugandan Vietnamese
To select multiple, hold CTRL/CMD and click.
Relationship Status Please select... Single Dating (Same-sex) Dating (Opposite-sex) Married (Same-sex) Married (Opposite-sex) Divorced (Opposite sex) Divorced (Same sex) Widowed (Opposite sex) Widowed (Same sex) Separated (Opposite sex) Separated (Same sex) Living w/ significant other (Opposite sex) Living w/ significant other (Same sex) Domestic Partner (Opposite sex) Domestic Partner (Same sex) Married Widowed Separated Divorced Living w/ Significant Other Domestic Partner Sexual Orientation Please select... Asexual Bisexual Gay Lesbian Pansexual Queer Questioning Straight Other Prefer not to say Are you a current college/university student? Contact Information Preferred Email (Required) Please select... Personal Work Preferred Phone (Required) Please select... Mobile Home Work Best Time to Call Please select... Anytime Daytime Evening Weekend In general, how do you prefer to be contacted? Please select... Email Phone Text/SMS Residential Address State Please select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming County Please select... Adams Allen Ashland Ashtabula Athens Auglaize Belmont Brown Butler Carroll Champaign Clark Clermont Clinton Columbiana Coshocton Crawford Cuyahoga Darke Defiance Delaware Erie Fairfield Fayette Franklin Fulton Gallia Geauga Greene Guernsey Hamilton Hancock Hardin Harrison Henry Highland Hocking Holmes Huron Jackson Jefferson Knox Lake Lawrence Licking Logan Lorain Lucas Madison Mahoning Marion Medina Meigs Mercer Miami Monroe Montgomery Morgan Morrow Muskingum Noble Ottawa Paulding Perry Pickaway Pike Portage Preble Putnam Richland Ross Sandusky Scioto Seneca Shelby Stark Summit Trumbull Tuscarawas Union Van Wert Vinton Warren Washington Wayne Williams Wood Wyandot Emergency Contact Information Relationship Please select... Adult Child Community Contact Co-Worker Employer Friend Neighbor Other Relative Parent Pastor/Clergy Roommate Sibling Spouse/Partner Teacher/Counselor Youth Service Organization Driver's License Information Do you have a driver's license? Please select... Yes No Employer Information
College/University Students - please select "Student: College" for Occupation and type "N/A" in for Employer. If you are retired, unemployed or a homemaker please select those options in drop down for Occupation. Occupation Please select... Agriculture Architect "Arts, Entertainment, Sports" Barber/Hairstylist Business Business: Clerical Business: Engineer Business: Human Resources Business: Marketing "Business: Mgt, Admin" Business: Sales Child/Day Care Worker Clergy Construction Consultant Craftsman Customer Service Disabled Education Education: Admin Education: College Professor Education: Teacher Education: Teacher Asst/Aid Engineer Facilities/Maintenance Factory Worker Finance Finance: Accountant Finance: Auditor Finance: Banking Finance: Economist Finance: Tax/Preparer Firefighter Fisheries: Commercial Fisheries: Sport Forestry Govt Govt: Clerical Govt: Mgmt/Admin Govt: Technician Govt. Mgmt/Admin Homemaker Human Services Human Services: Non-Profit Human Services: Psychologist Human Services: Social Worker Human Services: Youth Worker Insurance Janitorial Journalist/Media Laborer Landscape/Groundskeeper Landscaper/Groundskeeper Law Law: Judge Law: Lawyer Law: Legal Secretary Law: Paralegal Law: Police Officer Law: Security Officer Librarian Lifeguard Mechanic Medical Medical: Admin "Medical: Doctor, Provider" Medical: Healthcare Worker Medical: Nurse Medical: Pharmacist Military Mining Personal Trainer/Coach Real Estate: Realtor Retail: Mgt Retail: Sales Retired Scientist "Self-Employed, Entrepreneur" Service: Hotel Service: Restaurant Service: Tourism Student: College Student: High School Tech: Computer/Programmer Tech: Engineer Tech: Management Tech: Production Line Tech: Research/Design "Tech: Sales, Mktg" "Tech: Support, Writing" Transport: Driver Transport: Flight Attendant Transport: Mechanic Transport: Pilot Unemployed Unknown Additional Information
Level of Education Please select... Some High School High School Graduate Some College Associate Degree Bachelors Degree Masters Degree PHD No High School Juris Doctorate (JD) Doctor of Medicine (MD) Have you served in the military? Please select... No Yes - Active Yes - Reserves Yes - Retired/Vet What Prompted You To Apply Today? Were You Referred? Please select... Yes No Previous Experience
Have you previously applied to be or served as a Big Brother or Big Sister here or anywhere else? Please select... Yes No References
If no spouse or spousal equivalent reference is applicable, a family member reference is required. NOTE: The spouse or spousal equivalent reference is someone with whom the applicant cohabits and shares a long-term relationship, including a domestic partner.
Relationship to you Please select... Spouse/Partner/Significant Other Adult Child Other Relative Parent Sibling Professional/Educational Reference
Work or School Reference (not related to you) If you have been at your current employer for less than a year we also require a reference from your previous employer.
Relationship to you Please select... Employer Co-Worker Teacher/Counselor Have you worked for this employer for more than 1 year? Personal Reference
Relationship to you Please select... Community Contact Friend Neighbor Pastor/Clergy Roommate 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.) In addition to the references above, Big Brothers Big Sisters requires from all youth serving organizations at which you have worked or volunteered in the past. Please list additional on separate page, if needed. Please select... Yes No Pre-Interview Questionnaire
Prior to your in-person interview, please answer the questions below. The information you provide will also help us make a better match for you and assure we can support you during your involvement with our program.
Please note that you will have an opportunity to discuss these questions and your responses more thoroughly during your in-person interview. 1.Do you have any concerns about your ability to fulfill the 12 month commitment requires of mentors? 2.Do you anticipate any significant life changes over the next year or have you had any this past year? 3.Have you ever been accussed, arrested, charged, or convicted of a crime? 4.Have you had any driving citations and/or moving violations in the past five years? 5.Do you have guns, ammunition, or other weapons in your house? Photo Release for Promotional Purposes I do not consent to the use of identifying information and video, film and photographs in agency publications and promotional materials(including Facebook, Instagram & Twitter)
I have answered these questions honestly and completely to the best of my knowledge.
Why do you want to be a Big? Which type of activities do you enjoy more? Please select... Indoor Outdoor Indoor or Outdoor How would you describe yourself, in terms of participation in events, activities, or sports Please select... No Preference "Watch, not Participate" Participate: Individual Participate: Group Participate: Individual or Group Watch and Participate Would you be able to secure or otherwise make unavailable any inappropriate viewing material in your home? This would include, but is not limited to, television channels, internet access, printed material etc.? If no, we will have you discuss in interview. Do you anticipate any significant life changes over the next year or have you had any in the past year? Do you or anyone in your household have any life-threatening illnesses or medical conditions? (i.e. cancer, diabetes, Epilepsy/seizure disorders, Cardiac/heart conditions, severe asthma, severe allergies, or HIV/Aids) Or any medical issues that may affect your potential match? (i.e. upcoming surgery) Would you be willing to work with a child who has experienced physical, emotional or sexual abuse? What questions or concerns do you have about being a Big?
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(See attached authorization), 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' confidentially, 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 process, 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.
a. I understand that detailed accounts of child abuse or neglect, past or present, will be reported to proper authorities;
b. 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);
8) 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.).
9) I agree to complete questionnaires throughout my time in the program to evaluate and improve program services;
10) I agree to timely communication and follow-up with all agency staff as required by the agency.
PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING 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, accurate, 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 in 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 matters. I understand that BBBS staff needs to be fully informed to provide the best guidance or support possible.
If applicant us under the age of 18, co-signature of a parent/guardian is required for application and to obtain criminal history record check information: