Interested in Becoming a Big?
Please Note: This application is for volunteers who live in Wisconsin in Calumet, Outagamie, Waupaca or Winnebago counties. If you live outside of this area, please go to the Big Brothers Big Sisters of America national website, http://www.bbbsa.org, to search for your local agency.

If you are interested in becoming a mentor in Wisconsin in Calumet, Outagamie, Waupaca or Winnebago county, fill out the below application and click submit. FOR PROCESSING PURPOSES, ALL FIELDS MUST HAVE A RESPONSE.

A professional case manager will begin to process your information as soon as it arrives. You will be contacted so further steps can be taken to get you a little brother or sister.

On behalf of the more than 250 "waiting" children - thanks for your interest.

Full Name

Email Address

How did you hear about us?

Street Address, City, State, Zip

Home Phone Number

Work (w) and Cell (c) Phone Number

Please Check
Male   Female   

Ethnicity

Marital Status

Highest Level of Education

Employer, Occupation/Job Title

May we contact you at work?

Length with Current Employer and Average Work Hours

The question, Have you ever applied to be a BBBS before. If yes where?

Birthdate (Month/Day/Year)

Supervisor or Teacher's Name (who has known you for at least 1 year), Day Phone, Evening Phone & Email

Coworker/Neighbor (who has known you for at least 2 years), Day Phone, Evening Phone & Email

Significant Other/Close Family Member/Family Friend (who has known you for at least 3 years), Day Phone, Evening Phone & Email

Volunteer organization or other experience where you worked with children, Day Phone, Evening Phone & Email

 
I understand that checking this box means: This information does not obligate me to volunteer and BBBS is not obligated to match me with a youth.

 
I understand that checking this box means: The information I provided can be used to conduct a thorough background check, to include all records where required by law for volunteers working with youth.

 
I understand that checking this box means: Other BBBS agencies or other organizations where I have worked or volunteered may be contacted as references.

 
I understand that checking this box means: As part of the enrollment process, I will be asked to provide additional personal information prior to making recommendations for assignment.

 
I understand that checking this box means: I will provide true and complete information to BBBS staff throughout my screening process and program participation.

Indicate which city you would like to mentor in:

Please select program of choice
Community Based   School Based   Club Based