Application Received On-Line*
 
 
Application Received*
 
 
Check Volunteer*
 
 
a - Date of Application*
 
 
Program Ottawa*
 
 
 
c - Title
 
 
d - First Name*
 
 
e - Last Name*
 
 
- Gender
 
 
g - Date of Birth (MM/DD/YYYY)*
 
 
Pronoun*
 
 
h - Address (apt., number and street)*
 
 
 
 
i - City*
 
 
j - Province*
 
 
k - Postal Code*
 
 
l - Email*
 
 
Confirm Email*
 
 
m - Alternate E-Mail
 
 
n - Home Phone
 
 
o - Mobile Phone*
 
 
p - Business Phone
 
 
q - Preferred Language of Communication*
 
 
r - Additional Languages Spoken
 
 
 
ra - If bilingual would you be comfortable mentoring in French?
 
 
s - Marital Status*
 
 
si - Partner/Spouse Name
 
 
 
 
 
t - Emergency Contact Name*
 
 
ti - Emergency Contact Relationship*
 
 
 
u - Emergency Phone*
 
 
 
 
v - What is your country of origin?
 
 
w - Ethnic Identity
 
 
 
x - What is your immigration status?
 
 
y - Date of Arrival in Canada
 
 
 
 
Are you a former youth in care (Kinship, foster care?
 
 
 
- How did you hear about us?
 
 
 
 
za - Would you be interested in helping with Fundraising events?
 
 
 
 
zb - I would like to sign up for BBBSO’s Blog?
 
 
 
 
zc - I would like to sign up for BBBSO’s Monthly Newsletter?
 
 
 
 
 
 
Vulnerable Sector Reference and Experience
 
NOTE: A vulnerable sector check is an enhanced criminal record for individuals who have volunteered with children or vulnerable persons.
 
 
 
zd - Have you ever applied to or been involved with any Big Brothers Big Sisters agency before?
 
Yes
No
 
 
 
ze - If yes, with which agency(ies) were you involved?
 
 
 
 
zf - Please list any Bigs, Littles or Parents of Littles (or other volunteers or clients associated with BBBSO) whom you know.
 
 
 
 
 
 
 
We will contact all vulnerable sector agencies – please provide the following information.
 
 
 
zg - Agency/Organization
 
 
zga - When did you volunteer/work with this agency/organization?
 
 
zgb - For how long did you volunteer/work?
 
 
zgc - Contact Information
 
 
zgd - E-Mail
 
 
zge - Phone Number
 
 
 
 
 
zgf - Agency/Organization
 
 
zgg - When did you volunteer/work with this agency/organization?
 
 
zgh - For how long did you volunteer/work?
 
 
zgi - Contact Information
 
 
zgj - E-Mail
 
 
zgk - Phone
 
 
 
 
 
zgl - Agency/Organization
 
 
zgm - When did you volunteer/work with this agency/organization?
 
 
zgn - For how long did you volunteer/work?
 
 
zgo - Contact Information
 
 
zgp - E-mail
 
 
zgq - Phone
 
 
 
 
Employment & Education
 
 
 
 
zh - Employer
 
 
zi - Occupation
 
 
zj - Length of time in this position
 
 
zk - If less than 5 years, your previous place of employment
 
 
 
 
zl - Please indicate the highest level of education that you have completed
 
 
 
 
zm - Are you currently a student?
 
 
zn- If so, where?
 
 
 
zo - Grade / Level
 
 
 
 
 
Vehicle
 
 
 
 
 
zp - Do you own or have access to a vehicle? *
 
 
zq - Drivers Licence # (if none, insert N/A)*
 
 
 
NOTE: If you have a vehicle and plan to use it in your role as a volunteer, please upload below proof of $1,000,000 (one million) public liability insurance with your application. We require a copy of the ACTUAL insurance policy document (only the sheet that shows $1,000,000). You may also forward it by email at cindyd@bbbso.ca.
 
 
 
zr - File Upload
 
 
 
 
 
 
References
 
 
 
 
 
Please complete all sections fully. Incomplete reference information may cause delays in processing your application.
 
 
 
PLEASE BE SURE TO INPUT A VALID EMAIL ADDRESS FOR EACH REFERENCE.
 
 
 
Note: If you are involved in a relationship of significance (married, common-law, long-term partner/ boyfriend/ girlfriend) you must use this person as a reference.
 
 
 
Note: In addition to two individual references, volunteers applying for the Couples Match program will each provide one character reference from an individual who knows you as a couple.
 
 
 
Significant Other Reference
 
zs - Significant Other Name
 
 
zsa - Relationship to you
 
 
zsb - Years Known
 
 
zsc - Language Preference
 
 
zsd - Email
 
 
zsc - Mobile Phone
 
 
I confirm that if I have a significant other at present time, I've provided them as the reference.*
 
 
 
Volunteer Reference (or Employment Reference if no volunteer experience within the last 5 years)
zt - Volunteer Reference Name
 
 
zta- Relationship
 
 
ztb - Years Known (min 6 mths)
 
 
ztc - Language Preference
 
 
ztd - Email
 
 
zte - Mobile Phone
 
 
ztf - Employer Reference Name
 
 
ztg - Relationship
 
 
zth - Years Known (min 1 yr)
 
 
zti - Language Preference
 
 
ztj - Email
 
 
ztk - Mobile Phone
 
 
I confirm that I've provided a Volunteer Reference or Employer Reference*
 
 
 
Vulnerable Sector Reference
 
 
Note: If you have not volunteered with a Vulnerable Sector organization , you can leave this section blank.
zu - Vulnerable Sector Name
 
 
zua - Relationship
 
 
zub - Years Known
 
 
zuc - Language Preference
 
 
zud - Email
 
 
zue - Mobile Phone
 
 
 
Personal Reference Name
 
zv - Personal Reference Name*
 
 
zva - Relationship*
 
 
zvb - Years Known (min 2 yrs)*
 
 
zvc - Language Preference*
 
 
zvd - Email*
 
 
zve - Mobile Phone*
 
 
 
Family Reference
 
zw - Family Reference Name*
 
 
zwa - Relationship*
 
 
zwb - Years Known *
 
 
zwc - Language Preference*
 
 
zwd - Email*
 
 
zwe - Mobile Phone*
 
 
Please choose which category this reference belongs to:*
 
 
 
 
 
 

VOLUNTEER PERMISSION AND RELEASE AGREEMENT 

TO: Big Brothers Big Sisters of Ottawa (THE “AGENCY”) 

The Agency and Big Brothers Big Sisters Canada (“BBBSC”) are separate entities and this Agreement is between me and the Agency.  

1. By applying to volunteer with the Agency (“Volunteer Application”) and signing this Agreement, I acknowledge, understand and accept that: 
  • I am a legal resident of Canada and have reached the age of majority in the province or territory in which I reside. I acknowledge and agree that if I have not reached the age of majority of the province or territory in which I reside, my parent or legal guardian will also need to sign this Agreement in order for my Volunteer Application to be considered; 

  • There is no obligation on the Agency to accept my Volunteer Application or assign me as a volunteer into a mentoring program (a “Mentoring Program”) and the Agency may terminate my involvement in a Mentoring Program in its sole discretion and without reason; 

  • If I am accepted as a volunteer, my involvement in a Mentoring Program is not intended to create and shall not be construed as creating either an employee–employer relationship or a contract for services that would allow me to receive a salary, compensation, payment or any benefits, monetary or otherwise; and  

  • If I am accepted into a Mentoring Program, I understand that I will be required to enter into a confidentiality agreement with the Agency, and I agree to abide by the volunteer position description(s) and code(s) of conduct established by the Agency, including any applicable guidelines, Standards and policies. 
      

2. Assumption of Risk, Release and Reimbursement:

I acknowledge, understand and accept that: 

  • I am responsible for all risks associated with my involvement in a Mentoring Program including, without limitation, the risk of bodily or psychological harm or injury.  
  • Subject to local laws, I agree not to sue the Agency, BBBSC and/or any of their member agencies in respect of any such injury or claim resulting from my participation in a Mentoring Program, my Volunteer Application, the acceptance or denial of my Volunteer Application, the Alumni Program and/or my association with the Agency or BBBSC. 
  • I understand that I am fully responsible for any damage to my personal vehicle and/or property during my volunteer involvement in a Mentoring Program and that neither BBBSC nor the Agency insures personal vehicles or property belonging to its volunteers;   
  • I agree to reimburse the Agency and/or BBBSC and/or any of their member agencies for any damages or losses of any kind (including but not limited to the injury of any other person and/or damage to or loss of property) that may arise in connection with my gross negligence, wilful misconduct, or failure to act in accordance with published BBSC policies and guidelines and relating to or arising in connection with my participation in a Mentoring Program or my association with the Agency or BBBSC, including payment of any and all legal expenses of the Agency, BBBSC and/or any of their member agencies. 

3. Background Check.  I understand that my acceptance into the Mentoring Program will be conditional on my successful completion of a background check, which may include contacting the references included in my Volunteer Application and/or a criminal record check, for the purposes of confirming my suitability for the Mentoring Program. I agree to provide all necessary consents for such background checks.  

4. Privacy Notice.  The personal information provided by me or otherwise collected by the Agency in connection with my application will be used by the Agency  for the purpose of evaluating and considering my Volunteer Application and, if accepted into a Mentoring Program, for the purpose of administering the Mentoring Program. This information may include my name, phone number, mailing address, date of birth, results of background check, and driver’s license and auto insurance information.  My personal information will be maintained by the Agency on a confidential basis and will only be disclosed to the parent(s) and/or guardian(s) of a child with whom the Agency may consider “matching” me in a Mentoring Program, to representatives of a school or institution in connection with my participation in a site-based Mentoring Program, to the BBBSC as required for the purposes of accreditation reviews or legal proceedings and as otherwise required or permitted by law. In the event the Agency ceases operations, any and all information about me held by the Agency will be provided to BBBSC, another BBBSC agency selected by BBBSC, or both and will be used for the purposes set out above.  

In the event where it is deemed necessary, any and all information about me held by the agency will be provided to BBBSC, another BBBSC agency selected by BBBSC, or both and will be used for the purposes set out above. No information will be provided to persons or organizations outside of Big Brothers Big Sisters of Canada, and its agencies, about parents, children or volunteers without their express prior written consent except where required by law. 

5. Other Terms of this Agreement. 

(a) In entering into this Agreement, I am not relying on any oral or written representations other than as set forth in this Agreement.  

(b) This Agreement shall be governed by and construed pursuant to the laws of the Province or Territory in which the Agency is located. 

(c) In the event that any provision or term of this Agreement is held to be invalid, illegal or unenforceable, the remaining provisions of this Agreement shall remain in full force and effect. 

6. Media Consent. Any photographs or video productions taken of volunteers by agency staff at recreational events or match outings, or otherwise authorized by the Executive Director or Board of Directors, may be used by the agency for purposes of promotional material including brochures posters, newsletters, media information, advertisements, audio-visual productions and web pages, such as the Agency website and social media. Photographs or video productions may also be shared with community and school partners and Big Brothers Big Sisters of Canada for program promotion.  

 
zx - If you do not agree with item #6 Media Consent, please tick the check box
 
 
 
 
 
IMPORTANT: I acknowledge that I have read the terms of this Agreement, have been given an opportunity to obtain independent legal advice, and understand that it represents a waiver of certain of my legal rights, including my right to sue (subject to local laws). I further agree that such limits are reasonable and sign this Agreement freely, voluntarily and without duress. 
 
 
 
zy - By selecting this box and entering my full name and clicking Submit, I hereby attest that the information in this application is accurate to the best of my knowledge*
 
 
zz - Full name*
 
 
zza - Date*