BIG HOPE Volunteer Application Personal Information First Name:

Middle Name:

Home Address:

Last Name:

Apt#

Maiden Name : City:

County:

Home Phone #:

Work Phone #:

Cell Phone:

Date of Birth:

Gender:

Marital Status:

Male Female

Preferred Name to be called: State:

Zip:

Best time to call? Home Work Cell Nationality:

Ethnicity:

Email address: Applicant Occupation and Title:

Employer:

Address:

City:

State:

How Long Employed:

May we contact you at work?

Highest Education Degree Earned (minimum of HS required):

Are you currently a college student?

Social Security #:

Yes

DL #:

Have you previously applied to be or have you been a Big Brother or Big Sister? Yes No

Work Hours:

No Yes

Zip:

If yes, name of school:

No

DL State Issued:

Graduation Year:

DL Expiration date:

If yes, where:

Former staff member/MSS name, number and email:

When:

Former Little’s Parent name, number and email:

How did you hear about Big Brothers Big Sisters? Current Military Status:

Active Duty

Reserve

Veteran

Retired

Cadet

None

Other____________________

N/A

Are you interested in learning about additional ways to contribute to Big Brothers Big Sisters’ Mission? If yes – select interests that apply: Be a Donor Recruitment Volunteer Event Volunteer Fundraising Volunteer Invite BBBS to speak at your company Volunteer Youth Experience: Organization Name(s): Contact Name /Phone #: List any other organizations with contact info, where you worked and/or volunteered directly with youth within the last 5 years.

Please list previous volunteer activities: ___________________________________________________________

______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ Please indicate for what role(s) you would like to volunteer: _______ Prayer partner _______ Occasional special projects _______ Regular mentor (If so, please identify who you will ask to be your prayer partner):________________ _______ Substitute mentor If you are applying to be a prayer partner and or Special projects, your application is complete. Please return this to the KIDS HOPE director at your church. Prayer Partners & Special projects do not have to complete the screening process and reference checks unless they are considering being with a child at a future date. Mentors and Substitute Mentors are required to complete the additional information, below the dotted line, as part of the volunteer screening process. ***For promotional purposes, videos and photographs may be taken during the KHUSA mentoring hour or at KHUSA event. Occasionally, a photo of you may be shared with the KHUSA National Office to appear in the volunteer newsletter called Voices of Hope. Your application constitutes permission for KHUSA to use your picture in promotional material.

Please indicate the days and times you are available to give one hour: Monday Tuesday Wednesday

Thursday

Friday

a.m.

a.m.

a.m.

a.m.

a.m.

p.m.

p.m.

p.m.

p.m.

p.m.

Big Brothers Big Sisters

Big Hope Volunteer Application- August 2016

BI