BIG PROFILE FOR MENTORS
 
 
 
 
Please consider this my formal application to volunteer with Big Brothers Big Sisters of Saskatoon and Area, Inc. in the following program:*
 
 
Personal Information
 
 
 
Preferred Name
 
 
Legal First Name
 
 
Legal Last Name
 
 
How do you identify
 
 
 
If Not Represented, you may identify:
 
 
 
What pronouns do you prefer: (he, she, they, ze, etc)
 
 
 
Date of Birth (mm/dd/yyyy)
 
 
 
 
Street Address
 
 
City
 
 
Postal Code
 
 
Mailing Address (if different from above)
 
 
Mailing Address City
 
 
Mailing Address Province
 
 
Mailing Address Postal Code
 
 
 
 
E-mail
 
 
Alternate E-Mail
 
 
 
Home Phone (Land Line)
 
 
Mobile Phone
 
 
Business Phone
 
 
Preferred Form of Contact
 
 
Preferred Day to contact
 
 
Prefered Time Of Contact
 
 
 
Optional: Ethnicity / Nationality (This information is used for the purpose of calculating diversity statistics to enable Big Brothers Big Sisters of Saskatchewan to evaluate our progress to achieving a representative and diverse organization. Our goal is to have representation of the demographics of the diversity within Saskatchewan in our organization that reflects the community that we serve.): 
Ethnicity / Nationality
 
 
 
If First Nations, please indicate which First Nations:
 
 
 
Do you live with others (excluding immediate family)?
 
 
 
Marital Status
 
 
Partner/Spouse Name
 
 
 
If you are considering the Couples Match, how many years have you been in your relationship?
 
 
 
Do you have children?
 
 
Number and Ages of Children
 
 
 
Are you anticipating any major life changes in the next year?
 
 
Do you own or have access to a vehicle?
 
 
What is the level of your automobile insurance coverage?
 
 
 
Emergency Contact Information
Emergency Contact Name
 
 
Relationship to Emergency Contact
 
 
Emergency Phone 1
 
 
Emergency Phone 2
 
 
 
 
Is there a firearm in your home?
 
Yes
No
 
 
 
 
 
Employment and Schooling
 
 
 
What is your occupation? (if student indicate program)
 
 
 
Employer
 
 
Length of time at present employment
 
 
 
Does your work / school / other commitments take you out of town for extended periods of time?
 
 
 
 
Hobbies and Interests
Please list any clubs, affiliations or organizations of which you are a member?
 
 
Animals
 
 
Arts & Crafts
 
 
Building (Lego)
 
 
Board Games / Cards
 
 
Computers
 
 
Cooking
 
 
Cultural Activities
 
 
Dance
 
 
Educational Activities
 
 
Festivals and Local Events
 
 
Indoor Activities
 
 
Music
 
 
Outdoor Activities
 
 
Reading / Books
 
 
Sports
 
 
Talking
 
 
Video Games
 
 
 
What are your interest, hobbies, or activities?
 
 
You and Big Brothers Big Sisters
How did you hear about this program?*
 
 
 
Have you previously applied to or been involved with Big Brothers Big Sisters
 
 
 
If yes, where and when?
 
 
 
Why do you want to become a volunteer in the program now?
 
 
 
References
A minimum of 3 returned references are required.

  
Vulnerable sector Reference1 (if no volunteer or paid experienced exists in the vulnerable sector within the last five years, an employment reference is required)
  
Employer Reference Name
 
 
Employer Reference Address
 
 
Employer Reference City
 
 
Employer Reference Province
 
 
Employer Reference Postal Code
 
 
 
Employer Reference Email
 
 
Employer Reference Primary Phone
 
 
Employer Reference Secondary Phone
 
 
How long have you known this person?
 
 
In what capacity?
 
 
 
OR
 
 
 
Volunteer Reference Name
 
 
Volunteer Reference Address
 
 
Volunteer Reference City
 
 
Volunteer Reference Province
 
 
Volunteer Reference Postal Code
 
 
 
Volunteer Reference Email
 
 
Volunteer Reference Primary Phone
 
 
Volunteer Reference Secondary Phone
 
 
How long have you known this person?
 
 
In what capacity?
 
 
 
Significant Other (if no significant other exists, leave blank)
  
Significant Other Name
 
 
Significant Other Address
 
 
Significant Other City
 
 
Significant Other Province
 
 
Significant Other Postal Code
 
 
 
Significant Other Email
 
 
Significant Other Primary Phone
 
 
Significant Other Secondary Phone
 
 
How long have you known this person?
 
 
In what capacity?
 
 
 
Family reference (if no significant other exists or if significant other is less than 2 years, a family reference is required)
  
Family Reference Name
 
 
Family Reference Address
 
 
Family Reference City
 
 
Family Reference Province
 
 
Family Reference Postal Code
 
 
 
Family Reference Email
 
 
Family Reference Primary Phone
 
 
Family Reference Secondary Phone
 
 
How long have you known this person?
 
 
Family Reference Relationship
 
 
 
Personal Reference (must have known the applicant for at least two years)
  
Personal Reference Name
 
 
Personal Reference Address
 
 
Personal Reference City
 
 
Personal Reference Province
 
 
Personal Reference Postal Code
 
 
 
Personal Reference Email
 
 
Personal Reference Primary Phone
 
 
Personal Reference Secondary Phone
 
 
How long have you known this person?
 
 
Personal Reference Relationship
 
 
 
 
 
 
 
Is there anything else about yourself or your application that you'd like to share?
 
 
 
APPLICATION DECLARATION 

Background Check:
For the purpose of considering my Volunteer Application,

a) I consent to Big Brothers Big Sisters of Saskatoon and Area, Inc. contacting the references, in confidence, included in my Volunteer Application and I hereby waive the right to request disclosure of the personal references given about me.

b) I consent to Big Brothers Big Sisters of Saskatoon and Area, Inc. collecting information from any Big Brothers Big Sisters agency with which I am, or was formerly involved, including a Big Brothers Big Sisters agency in another country with which I am, or was formerly involved.

TO THE BEST OF MY KNOWLEDGE, THE ABOVE INFORMATION IS COMPLETE AND ACCURATE. I UNDERSTAND THAT THE INFORMATION CONTAINED IN THIS APPLICATION WILL BE HELD IN STRICT CONFIDENCE AND WILL ONLY BE USED TO ASSESS MY SUITABILITY AS A VOLUNTEER EXCEPT WHERE REQUIRED BY LAW. I UNDERSTAND THAT THIS APPLICATION BECOMES THE PROPERTY OF BIG BROTHERS BIG SISTERS OF SASKATOON AND AREA INC. AND SUBSEQUENTLY BIG BROTHERS BIG SISTERS OF CANADA.

 
TYPE NAME
 
 
 
 
By clicking this box I understand and agree to the terms of the application as referenced above.*
 
I Agree
 
 
 
 
 
 
Please Pick Todays Date*
 
 
 


Office Use 
 
 
Application Received On-Line
 
 
Saskatoon Agency Name
 
 
Application Received
 
 
Volunteer
 
 
 
 
If the submit button does not appear to work, please double check all your fields for correct formats such as dates, postal code, emails, or phone numbers.