Interested in Becoming a "Little?"
Thank you for your interest in considering our services for your child. Big Brothers Big Sisters of the Fox Valley Region is currently taking new applications for youth that are: • ages 6 through 14 • and living in the following areas: Appleton, Oshkosh, Combined Locks, Greenville, Kaukauna, Kimberly, Little Chute, Menasha, and NeenahIf your child meets the above criteria, please proceed to the client application below.Fill out the below application and click submit. 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 the child matched with a big brother or sister. FOR PROCESSING PURPOSES, ALL FIELDS MUST HAVE A RESPONSE.
Relationship to Child
Child's Full Name
Child's Date of Birth
Home Phone Number
Name of Employer
Work Phone Number
Cell Phone Number
What is the primary reason for referral for this child to have a Big Brother or Big Sister?
Do you feel this child has any conditions that will affect him or her relating to a Big Brother or Big Sister? If yes, briefly explain.
Does your child have other siblings who could benefit from having a Big Brother or Big Sister?
What days of the week and at what times would it be most convenient to meet with you and/or the child to conduct an interview?
Program of Interest
Community Based School Based Club Based Undecided
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.