Thank you for your interest in becoming a Big Brother or Big Sister.
Along with this application, you will need to submit a copy of a government-issued photo ID, as well as your driver’s license (if not used as your government-issued photo ID), and proof of current auto insurance with a summary of coverage. All applications will be given equal consideration regardless of race, age, sex, disability, marital status, sexual orientation, religion or national origin.
Possession of a driver’s license is required if you will be transporting a program youth in any vehicle you are operating.
Please list information for at least three references below including:
4. In addition to the references above, Big Brothers Big Sisters requires references from all youth-serving organizations
at which you have worked or volunteered in the past 5 years.
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’ confidentiality, 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 processes, 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 and with exceptions noted below.
8) I understand that incidents of child abuse or neglect, past or present, must be reported to proper authorities;
9) 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);
10) 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.).
11) I agree to timely communication and follow-up with all agency staff.
12) Publicity and promotional materials for Big Brothers Big Sisters are conducted in a variety of forms. I authorize Big Brothers Big Sisters to identify me in the media as a Big Brother or Big Sister using my full name. I also give permission for the use of other forms of media including but not limited to written word, photo, video, and voice recording. Please initial here______ to authorize.
13) COMPLIANCE WITH THE CIVIL RIGHTS ACT
Big Brothers Big Sisters of Yellowstone County (BBBSYC) complies with Title VI of the Civil Rights Act of 1964 and Section 504 of the Rehabilitation Act of 1973 as amended. BBBSYC services are provided without regard to an individual’s race, religion, creed, color, age, sex, national origin, disability, marital status or veteran status. If you believe discrimination is being practiced, you have the right to register a complaint with The Human Rights Bureau, Department of Labor and Industry, PO Box 1728, Helena, MT 59624-1728, 1-800-542-0807 and in Helena, 406-444-2884.
14) I will abide by the Big Brothers Big Sisters Confidentiality Policy: Due to the personal nature of the information shared by youth, parents/guardians, and volunteers, confidentiality is of great importance to us. Volunteer and youth files are secured, and access is available only to the professional staff, consulting professionals and Board Members who have received approval from the Board of Directors. Before a match is made, general information about the applicant which is considered relevant to the prospective match will be shared with the child’s parent/guardian. Parents/guardians have the right to refuse to enter into a match based on this information. Big Brothers Big Sisters volunteers are expected to respect the confidentiality of youth and their families at all times.
Exceptions to confidentiality:
a. Upon presentation of a consent to release information form signed by the volunteer.
b. For purposes of program evaluation, audit or accreditation within our organization.
c. Adherence to state laws mandating reporting suspected child abuse.
d. Pursuant to a valid, enforceable subpoena
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, correct 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 on 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 occurrences. I understand that BBBS staff needs to be fully informed to provide the best guidance or support possible.
VOLUNTEER PRE-INTERVEW QUESTIONNAIRE
Prior to your in-person interview, please answer the questions below. Parents of youth in our programs will often ask questions about someone with whom their child will be matched. 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.
BIG BROTHERS BIG SISTERS OF YELLOWSTONE COUNTY
POLICY ON CONFIDENTIALITY
I. Access to Confidential Records
In order for Big Brothers Big Sisters of Yellowsone County to provide responsible, professional service to clients, it is necessary for volunteers, clients and parents or guardians of clients to divulge extensive personal information about themselves and their families. The agency respects the confidentiality of client and volunteer records. Such personal information about clients and volunteers shall be shared only among the agency professional staff, with the exception of the specific situations described below.
Limits on Confidentiality
Policy on Confidentiality – 2
Nothing in this policy shall be interpreted as preventing the Executive Director from presenting a monthly program report to the Board of Directors. The program report may identify volunteers and children by name only throughout the match process from inquiry to closure. The Executive Director may summarize other information about the program not otherwise subject to the policy on confidentiality.
Each match party shall have the right to refuse the proposed match based on the anonymous information provided.
The information to be shared may include:
A. Volunteer: age, sex, race, religion, interests, hobbies, marriage and family status, sexual preference, living situation, reasons for applying to the program and a summary of why the individual was chosen for the particular match.
B. Child: age, sex, race, religion, interests, hobbies, family situation, living situation, a summary of the client needs assessment and expectations for match participation.
Safekeeping of Confidential Records
All case files and case notes, both active and closed, shall be kept in locking file cabinets. No files may be removed from the premises without approval of the Executive Director. Closed files will be retained by the Agency for a minimum of seven (7) years, or until the child reaches the age of twenty one (21), whichever comes first, after which time basic demographic information will be saved, and the remained of the record may be destroyed.
Violations of Confidentiality
Violations of confidentiality by agency personnel may result in disciplinary actions, including warnings, suspensions, or termination. Violations of confidentiality by volunteers and parents will result in warnings and if necessary, match closure.
I understand the agency policy with respect to confidentiality of client and volunteer records.
I agree to program participation under the conditions it sets forth.