Volunteer Application Form Step 1 of 4 25% Please indicate which position you are applying for(Required)1:1 Mentor in community1:1 mentor in schoolsGroup Mentor (Go Girls! or Game On!)New HorizonsGroup Mentor (Healthy Heroes)Name(Required) First Last Name you prefer to be called(Required) Gender(Required) Pronouns(Required) He/Him She/Her They/Them Other Phone(Required)Email(Required) Address (Please include unit # or relevant info)(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Date of Birth(Required) MM slash DD slash YYYY EthnicityFirst Nation/MetisInuitAfricanSouth AmericanCentral AmericanEuropeanIndo ChineseMiddle EasternSoutheast AsianAsian - all otherPacific IslanderFrench CanadianEnglish CanadianUndisclosedLanguages spoken in addition to English(Required) Are you a licensed driver?(Required) Yes - G Yes - G1 Yes - G2 No Do you have regular access to a vehicle?(Required) Yes No Do you have at least $1,000,000 of automobile insurance coverage? (to drive a participant in our programs this is the minimum requirement).(Required) Yes No Does not apply How did you hear about Big Brothers Big Sisters of London and Area?(Required)Always knownBrochureBusiness/CorporateFormerly a BigFormerly a LittleInformation boothNewspaperPresentationRadioSocial MediaSpecial eventTelevisionWebsiteWord of mouthName of person who referred you, if applicable Are you anticipating any changes in your life over the next year? (for example, marital status, moving, job changes, kids, etc)(Required) Yes No Comments FamilyMarital status(Required)SingleIn a relationshipDatingCommon lawMarriedDivorced / SeparatedWidow / WidowerPartner's name if applicable How does your partner feel about you volunteering with Big Brothers Big Sisters of London and Area?Do you have children?(Required) Yes No Number and ages of children EmploymentI am currently employed(Required)Full timePart timeSelf employedRetiredNot currently workingCompany Position Date of hire MM slash DD slash YYYY Average hours of work per weekEmployment shifts Days Evenings Nights Rotating Weekends Other Education HistoryPlease list your education history(Required)Name of schoolArea of studyDate of completionGraduated? Add RemoveAre you currently a student?(Required) Yes - full time Yes - part time No If you are a student, are you located in London until April, June, or year-round?(Required) Program Consideration ProfileWhen you consider your current schedule and commitments, when do you have time to mentor? Please indicate when you are available (for example: Weekdays after school; Thursday afternoons; Saturdays)(Required)Volunteer ExperienceDo you have experience working or volunteering with children?(Required) Yes No If yes, please identify (organization, role, and length of time)Have you ever applied to become a volunteer with any Big Brothers Big Sisters Agency?(Required) Yes No If yes, where and when? Please share any other volunteer experience you have had not listed above.(Required)Other InformationHave you ever had any involvement with the police?(Required) Yes No If yes, please give further details: About YourselfTell us why you want to become a volunteer with Big Brothers Big Sisters of London & Area.(Required)What personal strengths do you believe you have to offer?(Required)How do you feel you will be able to impact the life of a young person enrolled in our programs?(Required)Is there anything else you would like us to know about you?By clicking Submit, I consent to the collection of this personal information in accordance with Big Brothers Big Sisters of London and Area's Privacy and Confidentiality Policy.Untitled Facebook Twitter Google+ LinkedIn