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Volunteer Enrollment Form

Thank you for your interest in volunteering as a Big Brother or Big Sister! Fill out this secure, https protocol-protected online volunteer enrollment form below.

Submit your enrollment form online:

"*" indicates required fields

Step 1 of 2

50%

Consent

I agree to the privacy policy.

Policy on Eligibility of Volunteers

Please check each box to indicate that you have read and understand each item. Once you have agreed to all policies, you may proceed to the application.

Community-based program*

Must be 18 years of age or older.
Must be willing and motivated to engage in physical activities and keep up with a young person.
Must have time to engage in activities twice a month for several hours each time.
Must provide a copy of a valid driver’s license and a copy of your NC state minimum automobile insurance.

I have read and understand this policy

School-based/ After-school program*

Must be 16 years of age or older.
Must be willing to encourage educational success through help with assignments/ reading as well as board games, art, puzzles, etc.
Have reliable transportation to the program site.

I have read and understand this policy

All programs*

Be settled in employment and residence.
Be able to make a calendar year time commitment once you are matched.
Be able to be consistent in your contact with the youth and the organization’s staff.
Be interested in helping a young person improve interpersonal skills, experience a variety of activities, and develop higher aspirations.
Be interested in and willing to attend workshops that will help you ignite your Little’s potential.

I have read and understand this policy

Driver's License*

We cannot access motor vehicle records for the following states because our purpose is not employment: AL, AZ, DE, DC, KS, MA, MI, MT, NJ, OH, UT, VA, WV, WI and WY. So, please obtain a NC driver’s license and then submit an enrollment form.

I have read and understand this policy

Personal Information*

Provide complete and truthful information and share information of a personal nature. The enrollment process includes local and national criminal background checks. *Safety considerations: 3 moving/ safety violations in the previous 3 years will be evaluated during enrollment. Five offenses of any type in the previous 3 years will result in disqualification.

I have read and understand this policy

Mentorship*

Be able to demonstrate maturity, stability, and sound judgment to fulfill the role of a mentor. The following are important in working with children/ families in our program:
- Openness to values, living standards and lifestyles different from your own.
- Flexible approach to selecting activities, based on the interests of the child and goals of the match.
- A history of healthy interpersonal skills and relationships.
- Self-awareness, emotional and cognitive maturity appropriate to mentoring.

I have read and understand this policy

Screening*

A Screening Committee makes the decision about an applicant's acceptance or non-acceptance based on the above criteria. Once the Screening Committee approves a volunteer, the parent/ guardian decides if a volunteer is the best fit for their child. A match may not occur right away due to interests, preferences, and other factors.

I have read and understand this policy

Continuing Eligibility*

The above criteria are also used to determine continuing eligibility after a match with a Little Brother or Little Sister is made. The final decision regarding eligibility is entirely the program’s decision. It must be understood that the program does not have to explain the reasons for the decision when to do so would be in violation of the confidentiality policy or not in the applicant’s best interests.

I have read and understand this policy

Full Name (no initials)*

First Middle Last

Date of Birth*

MM slash DD slash YYYY

Gender*

Female

Male

Non-Binary

How did you hear about us?

Preferred pronouns

Home Address*

Street Address Address Line 2 City State ZIP Code

What county are you in?*

Local Mailing Address (if different)

Street Address Address Line 2 City State ZIP Code

Cell Phone*

Home Phone

Email*

Employer

Supervisor

Employer Address

Street Address Address Line 2 City State ZIP Code

Employer's Phone*

Race/Ethnicity*

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Hispanic or Latinx

Multi-Racial

Involvement with a Big Brothers Big Sisters Organization?

Yes

No

Where?

Program Specifics

PROGRAM CHOICE*

Please check the program for which you would like to apply. All of the following programs have an enrollment and matching process to ensure that the volunteer is matched with the right child for them.

Community-Based Program: Youth ages 6-14 are matched with volunteers ages 18+ for one-on-one activities twice a month for a minimum of one year. Matches are encouraged to participate in simple, fun activities designed to build a friendship

After-School Mentoring Program: Volunteers ages 16+ are paired with youth for fun activities one hour each week after school at the school or center. Time commitment: minimum of one calendar year.

School-Based Program: Volunteers ages 16+ meet with an elementary age child one hour a week during the school day. Matches engage in a variety of relationship-building and academic activities, such as crafts, reading and board games. Time commitment: minimum of one calendar year.

Preference of Elementary School

Reference Section

All information will be treated confidentially and will not be shared.

*For the School-Based or After-School Mentoring Programs: Please list 2 persons who have known you for at least a year, specifically:

1) Spouse/significant other (if not applicable, then a family member)

2) Work, School or Personal Reference

*For the Community-Based Program: List 4 persons who have known you for at least a year, specifically:

1 ) Your current/ past employer or co-worker

2 )A friend who has known you for at least 2 years

3) Your spouse/ significant other (if not applicable then a family member who is familiar with your home environment)

4) Someone who has observed you interacting with children (someone other than your parent)

Note name, city, phone number, email address, and relationship to you.

Example:
John Doe Asheville 828-771-9088 johndoe@gmail.com Employer

References*

Legal Record

Please list any arrests, convictions, and traffic violations. Please provide charge as well as disposition/result.

Citation/Arrest/Violation Date*

Have you been or are you on a Sex Offender Registry in any state?*

Yes

No

Social Security Number (https protocol-protected)*

Drivers License Number (include any & all zeros) (https protocol-protected)*

Issuing State of Drivers License*

Drivers License Expiration Date*

Address listed on Driver's License (Please send copy of Driver's License to Amanda Wrublewski at amandaw@bbbswnc.org OR fax enlarged copy to 828-253-5403.)*

Please list your residences for the previous 3 years for background check purposes*

Please include street address, city, state, zip code, and county. Example: 3 Keller Ct. Atlanta, GA 28803 Dekalb Co.

Agreement*

I agree to the terms & conditions.

I certify that all information entered on the volunteer enrollment form I am submitting is true and accurate.

Authority for Release of Information

During the application process and at any time during my service with Big Brothers Big Sisters of WNC, I hereby authorize First Advantage on behalf of Big Brothers Big Sisters of WNC to procure a consumer report which I understand may include information regarding criminal history, social security verification, motor vehicle records, or other background checks. I hereby authorize the obtaining of “consumer reports” and/or “investigative consumer reports” by the Company at any time after receipt of this authorization and throughout my volunteer service, if applicable. To this end, I hereby authorize, without reservation, any law enforcement agency, administrator, state or federal agency, institution, school or university (public or private), information service bureau, employer, or insurance company to furnish any and all background information requested by LexisNexis Screening Solutions Inc.,"First Advantage", another outside organization acting on behalf of the Company, and/or the Company itself. I agree that a facsimile (“fax”), electronic or photographic copy of this Authorization shall be as valid as the original. I understand that I may request a complete and accurate disclosure of the nature and scope of the background verification, to the extent such investigation includes information bearing on my character, general reputation, or personal characteristics.

Reference Release

I understand it will be necessary for Big Brothers Big Sisters of Western North Carolina, Inc., to check my character references and any references deemed necessary during the application process. I hereby give my consent for this information exchange and authorize such individuals to release information requested by Big Brothers Big Sisters of Western North Carolina, Inc. I understand that the individuals to be contacted will be employers, social services, and other individuals deemed necessary by Big Brothers Big Sisters of Western North Carolina, Inc. Other BBBS agencies or youth organizations where I have worked or volunteered may be contacted as references. I affirm that this information is accurate and truthful.

Confidentiality Policy

Big Brothers Big Sisters of WNC respects the confidentiality of client and volunteer records and, with the exception of situations listed below, shares information about clients and volunteers only among the agency professional staff. All records are considered the property of the agency and not the property of the agency staff, clients, or volunteers. Records are not available for review by the clients or volunteers.

- Information will be released to non-BBBS organizations or other individuals only with the client’s or volunteer's written consent.
Identifying information regarding clients and volunteers may be used in agency publications or promotional materials unless the clients or volunteer request otherwise.

- For purposes of program evaluation, audit, or accreditation, and with the prior approval of the Board of Directors, certain outside bodies such as Big Brothers Big Sisters of America may have access to client and volunteer records.
Members of the Board of Directors or evaluators appointed by the Board have access to client files upon authorization of the Board of Directors.

- Information shall only be provided to law enforcement officials or the courts pursuant to a valid and enforceable subpoena.
Information shall be provided to an agency's legal counsel in the event of litigation or potential litigation involving the agency.
State law mandates that suspected child abuse or neglect be reported to the Department of Social Services.

- If an agency worker receives information indicating that a client or volunteer may be dangerous to himself or herself or to others, necessary steps may be taken to protect the appropriate party. This may include a medical referral or report to the local law enforcement authorities.

- At the time a child or volunteer is considered as a match candidate, information is shared between the prospective match parties. Information about the volunteer that is shared with the parent/guardian may include such items as: age, sex, race, religion, interests, hobbies, marriage, family status, sexual orientation, living situation, etc. Information about the child that is shared with the volunteer may include such items as age, sex, race, religion, interests, hobbies, family situation, etc.

I agree to program participation under the above conditions.

Signature*

Please use your stylus, mouse, or trackpad to enter your signature.

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50 South French Broad, #213
Asheville, NC 28801

P (828) 253-1470
F (828) 253-5403

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Project MARS/AmeriCorps is supported by a grant from the North Carolina Commission on Volunteerism and Community Service in the Office of Governor Roy Cooper.

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