Big Brothers Big Sisters State Association of New Jersey
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Volunteer
First Name:
 Middle Name:
 Last Name:
 Date of Birth:
Home Address:
 City:
 County:
 State:
 Zip:
Email:
 Home Ph #:
 Work Ph #:
 Cell Ph #:
Male
Female 		Social Security #:
 Employer:
Occupation:
 Ethnicity:
 Marital Status:
 Highest Level of Education:
Can We Contact You At Work?
Yes   No 		Work Hours:
 How Long Employed?
Possession of a driver's license is not a requirement to participate in any of our programs but is required if you will be transporting a youth in any vehicle you are operating.
Do You Have A Driver's License?
Yes   No 		If Yes, State Of Issue And # Expiration Date?

REFERENCES

Please provide the information below requested for the following three references: 1) your current or past employer who has known you for at least 1 year; 2) a co-worker, friend or neighbor who has known you for at least 2 years; and 3) a close family member (spouse/domestic partner) or a second friend who has known you for at least 3 years.
1. Employer's Name (or school if student):
 Supervisor's Name (or teacher if a student):
Address:
 City:
 State:
 Zip:
Day Phone #:
 Fax #:
 Email:
2. Coworker or Friend or Neighbor:
Address:
 City:
 State:
 Zip:
Day Phone#:
 Fax #:
 Email:
3. Spouse/Domestic Partner/Friend:
Address:
 City:
 State:
 Zip:
Day Phone #:
 Fax #:
 Email:
Have you ever applied before (or have been) to be a Big Brother or Big Sister?
Yes   No 		Where and When:
What, if any, other youth organizations have you worked for or been involved with as a volunteer?
Have you ever been involved before with Big Brothers Big Sisters in a capacity other then a Big?
Yes   No 		Where and When:

I understand that:

  1. The references I listed may be contacted by mail, telephone, or email;
  2. I am in no way obligated to perform any volunteer services;
  3. The information I provided may be used to conduct a background check, to include driving records check, criminal background check, and other records where required by local, state, or federal law for volunteers working with youth;
  4. The BBBS agency is not obligated to match me with a youth;
  5. Other BBBS agencies or youth organizations where I have worked or volunteered may be contacted as references; and,
  6. As part of the enrollment processes, I will be asked to provide additional personal information prior to any recommendations for assignment.

I have read and understand the six (6) points listed above. Upon submitting this application I understand that the volunteer pre-enrollment process for Big Brothers Big Sisters (BBBS) includes motor vehicle, criminal, personal, and employment background checks. I authorize BBBS to conduct these checks to the degree to which it deems necessary. I understand that the information will be used to determine my eligibility for a volunteer position and that all information will be kept confidential.

I Agree

Signature:       Date:
         

Big Brothers Big Sisters State Association of New Jersey
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