Little Enrolment Form

This is the enrolment form for you child/youth. If you are enrolling more than one child, please complete separate forms. 

This enrolment form is for families residing in Toronto ONLY (i.e., an M postal code). If you do not reside in Toronto, please email enrolment.to@bigbrothersbigsisters.ca and we can direct you to the appropriate agency. 

Your child/youth must be between the ages of 7-15 to participate in our 1:1 programs. 

If you have any questions, please contact enrolment.to@bigbrothersbigsisters.ca
 
 
Section 1: Application Details
 
S.01.1. I am applying on behalf of my child to become a Mentee.*
 
 
 
S.01.2. Application Received*
 
 
 
 
 
S.01.3. Which program are you interested in for your child?*
 
 
S.01.4. How did you hear about us? (i.e. word of mouth, always known, referred by an organization - if you are referred from an organization, please provide which organization you were referred from)*
 
 
If your child identifies as non-binary or gender fluid, select program "Big Sibling" 
 
Section 2: Child Name
 
S.02.1. First Name*
 
 
S.02.2. Middle Name
 
 
S.02.3. Last Name*
 
 
S.02.4. Chosen Name
 
 
S.02.5. Preferred Pronoun (ex. he/him, she/her, they them)*
 
 
 
Section 3: Child Contact Information
 
S.03.1. Mobile Phone
 
 
S.03.2. Home Phone
 
 
S.03.3. Email*
 
 
 
Section 4: Child Address
 
S.04.1. Street*
 
 
S.04.2. City*
 
 
S.04.5. Postal Code*
 
 
 
Must reside in Toronto (i.e., M postal code) 
S.04.3. Province / Territory*
 
 
 
S.04.4. Country *
 
 
S.04.6. District Area*
 
 
MNC - North York, MNE - North Scarborough, MNW - Rexdale, MSC - Downtown, MSE - South Scarborough, MSW - Etobicoke
Check this map if you are unsure where you are in our District Areas: CLICK HERE for map 
 
Section 5: Child Personal Information
 
S.05.01. Date of Birth*
 
 
S.05.02. What's your gender identity?*
 
 
S.05.03. Gender: Self-Identify
 
 
Must be between ages 7-15 
 
 
 
S.05.04. Born in Canada?*
 
 
S.05.05. Tell us about your ethnic origin(s). Please select the one that best applies:*
 
 
 
S.05.06. Does your child identify as a member of any of the following communities? Please select one*
 
 
S.05.07. Other:
 
 
*Person of Colour (POC) refers to anyone who identifies as: South Asian, East Asian, Southeast Asian, Arab/West Asian, Latin/Central/South American 
 
 
S.05.08. Current status in Canada. Please select one:*
 
 
S.05.09. Date of Arrival in Canada
 
 
 
 
S.05.10. Preferred Language of Communication
 
 
S.05.11. Additional Languages Spoken
 
 
 
Section 6: Needs and Risks Identified at Referral

In order to meet your child’s needs best, please indicate if your child has been supported for or is affected by any of the following:

 
S.06.1. Living in Subsidized Housing
 
 
S.06.2. Learning or Literacy Issues
 
 
S.06.3. Chronic Physical Illness
 
 
 
S.06.4. Mental Health Issues
 
 
S.06.5. Violence or Abuse
 
 
S.06.6. Alcohol or Drug Abuse
 
 
 
S.06.7. Please tell us anything else you think we should know:
 
 
 
 
Section 7: Child Medical Information
 
S.07.1. Emergency Contact Name*
 
 
S.07.2. Emergency Contact Relationship*
 
 
(Other than primary caregiver contact)
 
S.07.3. Emergency Contact Mobile*
 
 
S.07.4. Child Health Card #
 
 
 
S.07.5. Does your child have allergies or dietary restrictions?
 
 
 
 
S.07.6. Does your child have any medical needs or conditions? If yes, please explain:
 
 
 
Section 8: Child School
 
If your child's school is not listed in the drop down menus, please select "other" (at the end of the list) and enter their school name in the cooresponding box. 
 
 
 
S.08.1. Name of School*
 
 
 
 
 
 
S.08.2. If your child's school is not listed, please enter here:
 
 
 
 
S.08.3. Teacher Name
 
 
S.08.4. Grade (enter number)
 
 
 
 
 
Referral Contact Information
(If applicable)
 
 
S.09.1. Referral Source
 
 
S.09.2. Referring Worker
 
 
S.09.3. Referring Worker Email
 
 
 
S.09.4. Other Professionals Involved
 
Yes
No
 
S.09.5. Other Referral Sources
 
 
 
 
Caregiver, Family, and Household Information
 
 
Section 10: Primary Caregiver
 
S10.01. Name of Parent/Caregiver*
 
 
S10.02. Primary Caregiver Email *
 
 
S10.03. Alternate E-mail
 
 
S10.04. Relationship to Child*
 
 
S10.05. Relationship Extra Info
 
 
S10.06. Lives with child?*
 
Yes
No
 
S10.07. Mobile Phone*
 
 
S10.08. Home Phone
 
 
S10.09. Business Phone
 
 
S10.10. Primary Caregiver Street 1
 
 
S10.11. Primary Caregiver Street 2
 
 
S10.12. Primary Caregiver Street 3
 
 
S10.13. City
 
 
S10.14. Province / Territory
 
 
 
S10.15. Postal Code
 
 
S10.16. Country
 
 
 
S10.17. District Area
 
 
MNC - North York, MNE - North Scarborough, MNW - Rexdale, MSC - Downtown, MSE - South Scarborough, MSW - Etobicoke
 
Section 11: Other Caregiver
 
S11.01. Other Caregiver Name
 
 
S11.02. Other Caregiver Email
 
 
 
S11.03. Relationship to Child
 
 
S11.04. Relationship Extra Info
 
 
S11.05. Lives with child?
 
Yes
No
 
S11.06. Mobile Phone
 
 
S11.07. Home Phone
 
 
 
S11.08. Other Caregiver Street 1
 
 
S11.09. Other Caregiver Street 2
 
 
 
S11.10. City
 
 
S11.11. Province / Territory
 
 
 
S11.12. Postal Code
 
 
S11.13. Country
 
 
 
 
Section 12: Family & Household Information
 
S12.1. Who does the child live with primarily?*
 
 
 
 
S12.2. How many siblings does the child have?*
 
 
S12.3. Family Access to Vehicle?*
 
Yes
No
 
 
S12.4. Only respond to this question if the child is living under the care of any welfare agencies (ex. Children's Aid Society, Catholic Children's Aid Society, Native Child and Family Services, Jewish Family and Child Services). What best describes their situation?
 
 
 
 
S12.5. Only respond to this question if the child's parents are separated or divorced. What best describes the custody of the child?
 
 
 
 
S12.6. If there is shared custody: do you have permission from non-custodial parent to register child? (note: consent must be granted by both parents/guardians with custody in order to enroll)
 
 
 

Section 13: Our Mentees are occasionally invited to apply for camps or post-secondary scholarships, in order to be eligible for such opportunities, please indicate your Household Income:

 
S13.1. Household Income
 
 
S13.2. Income Source
 
 
 
 
 
Section 14: Match Criteria
 
 
Is your child interested in any of the following?
 
S14.1. Animals
 
 
S14.2. Arts & Crafts
 
 
S14.3. Computers
 
 
S14.4. Building (Lego)
 
 
S14.5. Cooking
 
 
S14.6. Cultural Activities
 
 
S14.7. Board Games / Cards
 
 
S14.8. Educational Activities
 
 
S14.9. Dance
 
 
S14.10. Movies / TV
 
 
S14.11. Indoor Activities
 
 
S14.12. Festivals and Local Events
 
 
S14.13. Music
 
 
S14.14. Outdoor Activities
 
 
S14.15. Reading / Books
 
 
S14.16. Sports
 
 
S14.17. Talking
 
 
S14.18. Video Games
 
 
 
Section 15: When is your child available?
 
S15.1. During the School Day
 
 
S15.2. After School
 
 
 
S15.3. Weekday Evenings
 
 
S15.4. Weekends
 
 
 
 
Section 16: How would you describe your child?
 
S16.1. Friendly
 
 
S16.2. Quiet
 
 
 
S16.3. Highly Active
 
 
S16.4. Withdrawn
 
 
 
S16.5. Helpful
 
 
S16.6. Introvert (Shy)
 
 
 
S16.7. Extrovert (Outgoing)
 
 
 
 
 
Section 17: What is your child's interaction with animals?
 
S17.1. Do you have pets?
 
 
S17.2. Is your child comfortable around animals?
 
 
 
Section 18: Is there anything additional you want us to consider when matching your child?
 
S18.1. Please enter here:
 
 
 
 
 

Application Submission
 
 
 
Big Brothers Big Sisters agencies in Canada use a centralized online case file system. If your child has 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 your child was previously involved with. If you do not want your child's information shared with the previous agency you had contact with, please contact enrolment.to@bigbrothersbigsisters.ca. 
 
Date of Application*
 
 
 
 
 
 
 
Please slide the bar below to unlock the form before submitting 
 
 
 
 
 
IMPORTANT NOTE: If you are not directed to a 'thank you for submission' page, there is missing information on the form. Please go back through the form and look for a note in red that says "This field is required. Please enter a value."