How to apply: The easiest and fastest way to get started is to print and complete these forms. Once completed, please mail or bring them to your local office.

 

Pre-Interview Questionnaire for Littles

Activities and Interests for Littles

 

A Big Brothers Big Sisters staff member will contact you to schedule an in-person interview. If you have questions please contact your local office or go to Straight Scoop about Having a Big Brother or Big Sister.

 

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Match Participation – I give my permission for my child to participate in the Big Brothers Big Sisters program.  I understand that the BBBS agency is not obligated to match my child with a volunteer and that as part of the enrollment process I will be asked to provide additional personal information.  If my child is matched with a Big Brother or Big Sister I agree to support my child’s match and to immediately report any concerns I might have to the Big Brothers Big Sisters staff.

 

Confidentiality Policy – In order for BBBSNWWY to provide a responsible and professional service to its clients, it is necessary for volunteers, parents/guardians and clients to be asked to divulge personal information about themselves and their families.  The agency respects the confidentiality of client and volunteer records and generally shares information about clients and volunteers only among the agency’s professional staff.  However, for purpose of program evaluation, audit, or accreditations, and with prior approval of the Board of Directors, certain outside bodies, such as Big Brothers Big Sisters of America, may have access to volunteer and client records.  These outside organizations shall be required to respect the agency’s policy on confidentiality.  Big Brothers Big Sisters also retains the right to disclose information when such disclosure is in the best interest of the child and/or volunteer.

 

Media Consent – I hereby consent and agree that any photographs, films, video recordings, and/or audio recordings of myself and or my child, along with our names, may be used for advertising/publicity purposes by BBBSNWWY.  I waive any and all claims for compensation or royalties for such use and am not opposed to media coverage of my involvement with Big Brothers Big Sisters.

 

Passive Permission for Grant Funders – Big Brothers big Sisters of Northwest Wyoming (BBBSNWWY) is at this time (April, 2006) 92% grant funded.  In order to provide your child with a mentor, we have to meet expenses.  Grant funders require program evaluations.  Therefore, group student participant information must be compiled and mailed in annual progress reports.  We ask schools to fill out reports on attendance, participation, peer relationships, and academic performance for children involved in our program.  The information provides the statistics the grant funders require.  The information will be used to evaluate whether our program is positively impacting the youth we serve.  The individual student names are not on the reports.  The information provides accountability for our program and helps us improve our training to mentors.  The information will only be used for data compilation and no individual data will be used.  The evaluations are only to see how the group of participants is impacted by our program.  Once our program is funded by corporations and individuals and we no longer are dependent upon grant funding, this type of reporting will not be necessary.

 

 

Parent/Guardian signature:_______________________________Date:______________

Please indicate if you would like to Do, Watch, and/or Learn the following activities by circling the appropriate letter.  Feel free to write in activities that aren’t included.

 

Please check the activities that you especially enjoy.  Remember that your responses will

 

 

be used to match you with a Big Brother or Big Sister.  The more accurate your responses,

 

 

the easier it will be for us to match you with a compatible Big.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D   W  L

Skating (roller or ice)

 

D   W  L

Movies/TV/Plays

 

 

 

 

D   W  L

Horseback riding

 

D   W  L

Music (Insterments, Concerts, Records)

 

 

D   W  L

Camping

 

 

D   W  L

Dancing (Ballet, Gymnastics, Jazz)

 

 

D   W  L

Hiking

 

 

D   W  L

Gymnastics

 

 

 

 

D   W  L

Boating

 

 

D   W  L

Cars (Fixing, Racing, Go-Kars, etc)

 

 

D   W  L

Swimming/diving

 

D   W  L

Bowling

 

 

 

 

 

D   W  L

Games/cards

 

D   W  L

Crafts (Models, Macrame, Ceramics, Leather, Metal)

 

D   W  L

Pool/pinball

 

D   W  L

Art

 

 

 

 

 

D   W  L

Golf (Regular or Mini)

 

D   W  L

Animals (Pet care, Horses, Dog Training, etc.)

 

D   W  L

Tennis

 

 

D   W  L

Science

 

 

 

 

 

D   W  L

Ping Pong

 

D   W  L

Computers

 

 

 

 

D   W  L

Baseball/softball

 

D   W  L

Collecting (Coins, Rocks, Stamps, Books, Etc)

 

D   W  L

Football

 

 

D   W  L

Travel

 

 

 

 

 

D   W  L

Basketball

 

D   W  L

Martial Arts (Karate, Boxing, Wrestling)

 

 

D   W  L

Aviation

 

 

D   W  L

Reading

 

 

 

 

 

D   W  L

Hunting

 

 

D   W  L

Racquetball

 

 

 

 

D   W  L

Archery

 

 

D   W  L

 

 

 

 

 

 

D   W  L

Fishing

 

 

D   W  L

 

 

 

 

 

 

D   W  L

Bicycling

 

 

D   W  L

 

 

 

 

 

 

D   W  L

Motorcycling

 

D   W  L

 

 

 

 

 

 

D   W  L

Photography

 

D   W  L

 

 

 

 

 

 

D   W  L

Gardening

 

 

D   W  L

 

 

 

 

 

 

D   W  L

Cooking

 

 

D   W  L

 

 

 

 

 

 

D   W  L

Video games

 

D   W  L

 

 

 

 

 

 

D   W  L

Frisbee

 

 

D   W  L

 

 

 

 

 

 

D   W  L

Shopping

 

 

D   W  L

 

 

 

 

 

 

D   W  L

Jogging/track

 

D   W  L

 

 

 

 

 

 

D   W  L

Soccer

 

 

D   W  L