Program of Interest*
 
 
 
 
 
 
 
 
First Name*
 
 
Last Name*
 
 
 
Date of Birth (MM/DD/YYYY)*
 
 
 
 
Gender*
 
 
Gender identity
 
 
 
 
 
 
 
Address*
 
 
City*
 
 
Postal Code*
 
 
 
 
 
Preferred Form of Contact
 
 
 
 
Phone Number*
 
 
 
 
Email*
 
 
 
 
 
 
 
 
Have you ever applied or volunteered at any Big Brothers Big Sisters agency in Canada?
 
 
 
 
If yes, please provide with which agency/city and the years you were involved.
 
 
 
 
 
 
Please share your current employment and/or your school information below. 
 
Are you currently employed?*
 
Yes
No
 
 
 
If yes, who is your employer?
 
 
 
 
 
 
 
Are you currently attending school?*
 
Yes
No
 
 
 
If yes, which school do you attend?
 
 
What is your field of study?
 
 
 
 
 
 
 
Please note that access to a vehicle is required for the Big Brother/Big Sister Program, while it is recommended for the Big Bunch Program.
  
 
 
 
Do you own or have access to a vehicle? *
 
 
 
 
I have a minimum of $1 million general liability coverage.*
 
True
False
 
I have a class G2 or higher drivers license.*
 
True
False
 
 
 
 
 
 
 
You need to provide 3 references as part of your application:
  1. Significant other reference
  2. Vulnerable sector reference
  3. Personal reference (See explanations below)

Please contact your references to inform them that Big Brothers Big Sisters of Waterloo Region will be emailing them to provide a reference for you and that their reference is required promptly so we can proceed with your application.

 
 
 
 
 
Vulnerable Sector Reference

If you have worked or volunteered with vulnerable people (children, elderly, people with disabilities etc.) in the past 5 years, please provide us with a reference of someone who supervised you during this time (this must be someone who supervised you and CANNOT be a family member).

If you have NOT worked or volunteered within a vulnerable sector in the past 5 years, please provide an employment or volunteer reference (this must be someone who supervised you and CANNOT be a family member).

 
 
 
 
Reference Name*
 
 
Relationship to Yourself*
 
 
Email*
 
 
Phone #*
 
 
 
 
Current City of Residence
 
 
 
 
Organization Name
 
 
Role at Organization
 
 
 
I confirm that the reference provided above is someone I directly reported to and not a family member.
 
 
 
 
 
 
 
 
Significant Other Reference

If you do not have a significant other, please leave blank, and provide us with a family reference.

A significant other reference is someone you view currently as a significant part of your life who has known you for at least 2-years. This could be someone you are dating, living together with, a common-law partner, or married to. 
 
 
 
Reference Name
 
 
Relationship to Yourself
 
 
Email
 
 
Phone #
 
 
 
 
Current City of Residence
 
 
 
 
I confirm that if I have a significant other at present time, I've provided them as the reference.
 
 
 
 
 
 
 
 
Family Reference

This should be any member of your family that you have current and consistent contact with. Ex. parent, sibling, cousin, etc.  
 
 
 
Reference Name*
 
 
Relationship to Yourself*
 
 
Email*
 
 
Phone #*
 
 
 
 
Current City of Residence
 
 
 
 
I confirm that the reference provided above is a family member.
 
 
 
 
 
 
 
 
Personal Reference

This should be a friend, co-worker, or neighbour you have known for at least 2 years. Please note, this cannot be a family member. 
 
 
 
Personal Reference Name*
 
 
Relationship to Yourself*
 
 
Email*
 
 
Phone #*
 
 
 
 
Current City of Residence
 
 
 
 
I confirm the reference provided above is not a family member.
 
 
 
 
 
 
 
 
I authorize the references above to be contacted by Big Brothers Big Sisters of Waterloo Region*
 
 
 
 
 
The above references are aware that they will be contacted*
 
 
 
 
Your application is almost complete...

Please review both the Volunteer Permission and Release Agreement and Confidentiality Policy before you proceed. You will be asked to sign a copy of this during your interview. 
 
 
 
I have read and agree to the terms of the Volunteer Release Agreement and Summary.*
 
 
 
 
 
I have read and agree to the terms of the Confidentiality Policy.*
 
 
 
 
 
I acknowledge that the information I have provided is true to the best of my knowledge. I authorize Big Brothers Big Sisters of Waterloo Region to use the information I provided within their agency.*
 
 
 
 
 
First Name
 
 
Last name
 
 
 
Please enter today's date (MM/DD/YYYY)*
 
 
 
 
 
 
 

Big Brothers Big Sisters agencies in Canada use a centralized online case file system. If you have been involved in the past with another Big Brothers Big Sisters agency in Canada, the information you submit in this form will be transmitted and shared with both the agency you are applying to, along with the agency you previously were involved with. Should you have any questions regarding the above, please contact info@bbbswr.org for more information.