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Big Brothers Big Sisters Volunteer Application

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Non-Discrimination Policy

Thank you for your interest in becoming a Big Brother or Big Sister. All applications will be given equal consideration regardless of race, age, sex, disability, marital status, sexual orientation, religion, national origin, gender, or gender identity/expression.


Direct questions to [email protected] or in-person or via postal service to 401A Tiny Town Road, Clarksville, TN 37042. 

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Contact Information

























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Additional Information








References and Background Check

Previous Experience










Volunteer Experience











Please provide at least three references below including:
  • Your spouse or domestic partner OR a family member if you do not have a spouse, partner, or significant other.
  • Current or former employer or co-worker you have known for at least one year or someone from your school if you are a student
  • A friend or neighbor you have known for at least two years
Spousal/Familial Reference







Professional Reference







Minimum 1 year
Personal Reference







Minimum 2 years
I consent to and understand that:
  1. The references and youth-serving organization(s) I listed may be contacted by mail, telephone, email, or in person;
  2. The information I provided may be used to conduct a background check, to include a search of public domain records, driving records check, juvenile and adult criminal history check (see attached authorization), military records, and other records where required by local, state, or federal law for volunteers working with youth;
  3. I am in no way obligated to perform any volunteer services;
  4. The BBBS agency is not obligated to match me with a youth and may deny my application or close my match at any time, and to protect all participants’ confidentiality, BBBS is not required to disclose reasons for doing so; 
  5. Other BBBS agencies and youth organizations where I have worked or volunteered may be contacted as references;
  6. As part of the enrollment processes, I will be required to provide additional personal information, including completion of an in-person interview;
  7. I understand that the information I provide in the enrollment process will be kept confidential, unless disclosure is required by law.  
  8. I understand that detailed accounts of child abuse or neglect, past or present, will be reported to proper authorities;
  9. I understand that certain relevant information about me will be discussed with the parent/guardian of a child who is a prospective match (this might include demographic information, information relevant to parent/child preferences, and any information relevant to a child’s safety or well-being);  
  10. It is my responsibility to update the agency if any of the information I provide on this application, in my interview, or any other information provided during the enrollment process changes (i.e. address, phone number, auto-insurance, new criminal charges, etc.)
  11. I agree to complete match support calls as required, as well as complete surveys throughout my time in the program to evaluate and improve program services;
  12. I agree to timely communication and follow-up with all agency staff as required by the agency.

Pre-Interview Questionnaire

Parents of youth in our programs will often ask questions about someone with whom their child will be matched.  The information you provide will also help us make a better match for you and assure we can support you during your involvement with our program.  

Please note that you will have an opportunity to discuss these questions and your responses more thoroughly during your in-person interview.  















Please provide the name, age, and relationship to you for anyone else residing in your home.
















Agency Weapons Policy

Big Brothers Big Sisters of Clarksville requires that ownership of any firearms and/or weapons by a Big applicant be: 

  • Disclosed to Big Brothers Big Sisters Agency Staff at time of enrollment and throughout the life of the match; 
  • Disclosed to the child’s parent/guardian by Agency Staff; 
  • The Volunteer Big must attest to the fact that any weapons, firearms or ammunition ownership are licensed, permitted, registered, and handled in accordance with all applicable state and federal laws. 


Volunteer Big and parent/guardian will review and agree to the Big Brothers Big Sisters of Clarksville agency guideline below which will be kept in the match file: 

  • Weapons, firearms and ammunition will be made inaccessible at all times to a child while in the Big’s care, unless participating in specific agency approved activity(ies), which the parent/guardian and Volunteer Big have approved in advance and such approval is documented in the match file (e.g. hunter safety courses).





Please check any areas of interest and activities that you would enjoy doing with your Little.
(Select all that apply)






Release of Information Authorization for Background Check

All volunteers and members of the volunteer household over the age of 18 must provide their social security number so that ongoing layered criminal background checks may be conducted and the volunteer and members of the volunteer household may be verified through the BBBSA network.  All volunteers and members of the volunteer household over the age of 18 must sign consent for a motor vehicle registry check, layered national criminal background check and be cleared on national and Tennessee sex offender registries.

Big Brothers Big Sisters of Clarksville adheres to all applicable federal, state, and local laws regulating the use of criminal records. Volunteer applicants, current Bigs, Board members, and Agency Staff, will be disqualified for:
  • Failure to complete the application and screening process;
  • Past history of sexual abuse of children; 
  • Conviction for any crime in which children were involved;
  • History of any sexually exploitive behavior; and
  • Termination from a paid or volunteer position caused by misconduct with a child.


Volunteer Confidentiality Agreement

As a volunteer with Big Brothers Big Sisters of Clarksville, I understand that I may become aware of certain confidential information which includes, but is not limited to: 

·        Medical and personal information concerning Littles and their families 

·        Information regarding the provision of services 

1) It is expected that I will keep such information in the strictest confidence. 
2) I understand that this confidentiality agreement will be kept on record at Big Brothers Big Sisters of Clarksville. 
3) I understand that any information that is shared will be done so only with the permission of the Little's Parent/Guardian and only when appropriate to serving the best interest of the Little.


The undersigned acknowledges and agrees that any normal limits on confidentiality do not apply in the case of negligence, instances of physical or sexual abuse, or if applicant is deemed to be a danger to himself/herself/or others, and that such information as the agency may have in these matters can be used in civil or criminal proceedings. I am in no way obligated to perform any volunteer services. As part of our enrollment processes, I will be required to provide additional personal information, including completion of an in-person interview; understand that the information I provide in the enrollment process will be kept confidential unless disclosure is required by law and with exceptions noted below. 

  • ·     I understand that incidents of child abuse or neglect, past or present, must be reported to proper authorities; 
  • ·     I understand that certain relevant information about me will be discussed with the parent/guardian of a child who is a prospective match (this might include demographic information, information relevant to parent/child preferences, and any information relevant to a child's safety or well-being); 
  •       For purposes of program evaluation, audit, or accreditation, and with the prior approval of the Board of Directors, certain outside bodies such as BBBS of America may have access to records.


Big Brothers Big Sisters of Clarksville recognizes that online social networking (Facebook, Myspace, Twitter, Linkedin, Blogs, etc.) has become a very popular communication tool and that many of our Big Brothers/Sisters, Little Brothers/Sisters and their guardians use these websites. It is not possible for Big Brothers Big Sisters of Clarksville to monitor all communicating by its participants on these sites and therefore Big Brothers Big Sisters of Clarksville has created this policy to provide guidance on the use of these social networking sites within the context of the match. In general, personal use of social networking sites is typically for communications between peers, including friends and family. A volunteer is advised to proceed thoughtfully when inviting or accepting an invitation to a social networking site. A volunteer, parent or youth are advised that any doubts should be discussed with the Match Support Specialist. 


Volunteer Social Networking Policy If the volunteer chooses to participate in social networking site with the Little, the volunteer has been given the Social Media Policy at the match introduction and trained to adhere to the following guidelines regarding any postings related to the match or affiliation with Big Brothers Big Sisters of Clarksville. The volunteer is advised that the failure to adhere to these guidelines may result in the closure of the match. Examples and more detail are provided to all volunteers in the interview or in ongoing match support. A volunteer must adhere to the following guidelines regarding any postings related to your match or affiliation with Big Brothers Big Sisters of Clarksville. 


a) Do not participate in any online communication with/about your Little/Guardian unless you have discussed this with the Parent/Guardian and your Match Support Specialist and have received their approval.

b) Never post any pictures of your Little/Guardian online unless you have written consent of the child’s parent/guardian. That consent should be filed with Big Brothers Big Sisters of Clarksville staff. 

c) Never post the last name of your Little, his/her parent/guardian or Big Brothers Big Sisters of Clarksville Staff. 

d) Never post any contact information for your Little/guardian. 

e) Never post any identifying information about your Little/guardian (child’s home address, school the child attends, where the parents work, etc.) 

f) Never post anything that could be perceived as judgmental or offensive to your Little or his/her parent/guardian. 

g) Make sure that your page settings are set to private, so that only people you approve can view your online content. 

h) Honor confidentiality guidelines within your match, be cautious when posting detailed information about conversations with your Little, their parent/guardian or with Big Brothers Big Sisters of Clarksville staff.

i) Posting generalized information or status updates is typically appropriate, but lengthier postings or blogs containing in-depth information should be approved by the parent/guardian and by Big Brothers Big Sisters of Clarksville prior to posting. 

Program Acceptance

Media Consent and Release

I irrevocably consent to any and all uses and displays of my name, image, likeness, appearance, basic biographical information, audio/video recordings, writings, artwork, and the like, in original form or in modified form, in whole or in part, in, on, or in connection with merchandise, advertising, publicity, marketing, fundraising, and the like, in printed or electronic media, of any type, throughout the world at any time by Big Brothers Big Sisters of America and [BBBSA affiliate] in their sole discretion, and by any of their affiliates, successors, partners, sponsors, donors, any entities or persons with whom they conduct any public relations, marketing, or fund raising of any type, and any other authorized third parties, without further consent from me, without any royalty, payment, or other compensation to me, and with the release and waiver of any claims, actions, damages, losses, costs, expenses and liability of any kind arising from any such use (the “Released Material”).
In consideration of the mutual promises made herein, and for other good and valuable consideration, the receipt and sufficiency of which I hereby acknowledge, I hereby grant to BBBSA and its affiliates the right to use the Released Material as BBBSA and/or its affiliates may desire, in all media now existing or hereafter created and in all variations and forms including, but not limited to, internal or external publications or productions, informational or recruitment materials, marketing materials, fundraising materials, televised photography and/or recordings, advertisements, Public Service Announcements, and/or online and social media sites. The use of this information shall be at the sole discretion of BBBSA and/or its affiliates.

I further grant to BBBSA and its affiliates the absolute right to use the Released Material in whole or in part, alone or in conjunction with any other image, name, writings or reproduction, in color or otherwise, for art, advertising, business, trade, or any other lawful purpose whatsoever, in perpetuity throughout the world.

I understand and agree that all materials created by BBBSA and/or its affiliates that use the Released Materials are the property of and are owned by BBBSA, and that I cannot authorize their use by any other party.  I further understand that BBBSA may authorize their use by a third party. I hereby irrevocably transfer and assign to BBBSA my entire right, title and interest, if any, in and to the Released Materials and all copyrights in the Released Materials arising in any jurisdiction throughout the world, including the right to register and sue to enforce such copyrights against infringers.

I acknowledge and agree that I have no right to review or approve the Released Materials before they are used by BBBSA and/or its affiliates, and that BBBSA has no liability to me for any editing or alteration of the Released Materials or for any distortion or other effects resulting from BBBSA’s and/or its affiliates’ editing, alteration or use of the Released Materials.  BBBSA has no obligation to use the Released Materials or to exercise any rights given by this Consent and Release Form.

I hereby release BBBSA and its affiliates, employees, and agents, as well as any partner companies, from all claims, demands or liabilities and related financial costs that I may now or hereafter have arising in connection with BBBSA’s exercise of the rights hereby granted, and/or with the appearance or the Released Materials in any publication or production. These include, without limitation, claims for compensation, defamation, or invasion of privacy, or other infringements or violations of personal or property rights of any sort whatsoever.


Child Safety Guidelines and Ground Rules for Volunteers                                                                      

CRIMINAL HISTORY RECORD CHECK POLICY
A criminal history record check is required of all Volunteer Bigs, potential Board members, Big Brothers Big Sisters of Clarksville agency staff, and non-mentoring volunteers who come into meaningful contact with children. Confirmation of the person’s identity is obtained by government issued photo ID or social security verification.

Volunteer Bigs, board, and staff require a layered criminal history check. Non-mentoring volunteers that will come into meaningful contact with children require a criminal record check.

Updated criminal history record checks of board members, staff, and volunteer Bigs (while in an active match) and Motor Vehicle check will be conducted every 3 years with results recorded in MATCHFORCE or action taken if there are problems identified.
 

IN-DEPTH REFERENCES POLICY 
As one of the three required references for community-based volunteers, professional agency staff will carry out an in-depth reference by phone or in-person from the spouse/spousal equivalent (or when there is no spouse/spousal equivalent, the reference must be with a family member), in order to assess child safety in the volunteer applicant’s home and to gain additional insight into the applicant’s qualifications and appropriateness to serve as a Volunteer/Big.

TRANSPORTING CHILDREN POLICY 
All Bigs and Agency Staff are required to provide verification of appropriate licensure, provide proof of insurance annually and are expected to follow safety requirements in accordance with state laws (e.g. seat beats use, car seat use, prohibitions on use of cell phone, alcohol or other drugs prior to driving a child).

CHILD SAFETY & YOUTH PROTECTION TRAINING POLICY
Bigs, parents/guardians, and children must receive child safety and youth protection training prior to matching, which must be documented in the file. 

VISITS TO BIG’S HOME, OUT OF TOWN TRAVEL, & OVERNIGHT VISIT POLICIES 
Policy on Children Visiting Volunteer Applicants’ Home 
The timing of visitation to the Big's home will be decided by the match support specialist in consultation and with the approval of the guardian. The match support specialist, parent, child and volunteer will discuss if the child is comfortable going to the home and if there are any developmental reasons related to child safety not to allow the visit. The match support specialist will also have a discussion with all parties to reinforce the personal safety education information provided to all parties at enrollment/pre-match. The first visit to the home of the volunteer requires specific approval from guardian and match support specialist. The match support specialist will continue to evaluate the safety level of activities that take place in the volunteer's home. 

A match support specialist has the authority to restrict the volunteer and Little's activities at the volunteer's home if there are concerns regarding the safety level or appropriateness of such visits. In that case the parent/guardian and volunteer will be informed of the professional staff's decision. 

Policy on Overnight Visits 
Big Brothers Big Sisters of Clarksville recognizes that in long-term match relationships these visits may be an important part of some activities and may be valuable to the match participants in developing their one-to-one relationship. Therefore, overnight visits are allowed after one year of the match relationship BUT are limited to special occasions with prior approval. After being matched for one year, a match may seek agency approval to have an overnight visit, though approval rests in the discretion and professional judgment of the match support specialist and Executive Director. 
The following conditions must be met before an overnight visit may be granted: 
  • The match must have been in effect for at least 1 year. 
  • Match support contacts for the last 3 months should be reviewed by the Match Support Specialist before granting permission. 
  • The Big has consistently demonstrated good judgment, reliability, and commitment to the Little. 
  • The Big, Little and Parent/Guardian have adhered to the Match Agreement & Guidelines. ? Overnights may occur when special activities or events arise that promote youth education, life skills, leadership development, college or career exploration, participation in outdoor sports or environmental activities. 
  • The match support specialist and their immediate supervisor is responsible for determining whether overnights for the match are appropriate and whether they meet conditions for approval. Before making a decision, the match support specialist will have a conversation with all parties regarding the purpose of the trip, reinforce policies regarding supervision and transportation, and assess whether accommodations will allow for privacy for sleeping, showering, and changing clothes.

Policy on Out of Town Travel
Out-of-town or state travel is permitted with the approval of the parent/guardian. However, if such travel requires overnight stay, the policy is the same as for any overnight visit, and appropriate consent and release forms must be completed by the parent/guardian and volunteer. 

Application Acknowledgement

I understand that this is an application for a volunteer opportunity and is not a promise or commitment by Big Brothers Big Sisters.

I certify that all information I have provided or will provide to Big Brothers Big Sisters, including this application, is true, accurate, and complete to the best of my knowledge. I certify that I have and will answer all questions to the best of my ability and that I have not and will not withhold any information that would affect my application for a volunteer position. I understand that information contained in my application will be verified by Big Brothers Big Sisters. I understand that misrepresentations or omissions may be cause for my immediate rejection as an applicant or my termination as a volunteer.

At any time while involved with the Big Brothers Big Sisters program, I agree to immediately inform my Big Brothers Big Sisters contact person of any and all infractions, violations, charges, and convictions related to any civil, domestic, or criminal matters.  I understand that BBBS staff needs to be fully informed to provide the best guidance or support possible.  

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Contact Information

BBBS OF CLARKSVILLE

401-A Tiny Town Road
Clarksville, TN 37042
Phone: (931) 647-1418
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