High School Volunteer Application

High School Volunteer Application
Thank you for your interest in Big Brothers Big Sisters of Central Montana! Please complete the following application and have a parent or guardian review and sign the final section before submitting.
First Name
Last Name
Preferred Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Gender
School
Grade
Phone Number
Email Address
Home Address (House/Apartment #, Street, City, ZIP)
Mailing Address (if different)
Race/Ethnicity
Nationality
What day(s) and time(s) are you available to participate in the program?
Do you have any current or upcoming time constraints or obligations such that could prevent you from meeting the requested time commitment to BBBS?
Please use this space for any questions or to share any other information you feel is relevant.
Volunteer Reference
Please give the name and contact number of a teacher or school counselor who recommends you as a volunteer in the Big Brothers Big Sisters program.
Name
Phone Number
Email Address
Relationship to you
Please read the following carefully before signing this application:
I understand that:
1. All Big Brothers Big Sisters (BBBS) participants, including youth, families, volunteers, board and staff serving as volunteer Bigs are not excluded on the basis of race, ethnicity, religion, national origin, color, gender, marital status, sexual orientation, gender identity, gender expression, citizenship status, veteran status, or disability.
2. BBBS is not obligated to match me with a child and may deny my enrollment or participation at any time and for any reason.
3. I am in no way obligated to perform any volunteer services.
4. The references I listed may be contacted by mail, telephone, email, or in person.
5. Other BBBS agencies or youth organizations where I have worked or volunteered may be contacted as references.
6. I certify that the information provided is accurate.
Student Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Parental Consent:
Your child has the opportunity to participate in the Sit Based Mentoring Program! In this program, your child is paired with a student from a local elementary school, and they will visit together once per week to play games, read, work on schoolwork, etc. The supervised activities take place during the school day at the elementary school. If you would like your child to participate, please complete the information below.

By signing, you give permission (1) for your child to participate in the Big Brothers Big Sisters program, (2) to have your child complete a brief interview to determine their suitability for the program, and (3) for Big Brothers Big Sisters to use your child’s photograph for our social media, marketing, and informational purposes.

If you have any questions, please contact Program Director, Tiffany Roman at tiffany@bigcentral.org or (406) 204-0108.
Parent/Guardian Name
Phone Number
Email Address
Please use this space for any questions or to share any other information you feel is relevant.
Parent/Guardian Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

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
Hispanic - Other Latinx or Spanish Origin
Hispanic - Puerto Rican
Middle Eastern or North African
Other
Pacific Islander - Chamorro
Pacific Islander - Native Hawaiian
Pacific Islander - Other
Pacific Islander - Samoan
Prefer not to say
White or Caucasian

High School Volunteer Application

Volunteer Reference

Please read the following carefully before signing this application:

Parental Consent: