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Full Name (*)
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E-mail (*)
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Street name and number (*)
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City: (*)
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State (*)
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Zip Code
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Home Phone 5555555555
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Cell Phone 5555555555
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Age
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BirthDate - mm/dd/yy (*)
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Current Student?
NAU CCC FHS CHS SHS Other Not Applicable
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Full Time Flagstaff Resident
Yes No
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Where did you hear about BBBSF?
BBBSF Board/Staff College Partner Faith Organization High School Partner Media Neighbor/Friend Other Big Relative Self Service Organization Special Event Web Link Workplace Partner
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Match Types
Community-Based Match School-Based Match Other (Step-Up, GEAR UP) Undecided
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I understand that:
• This interest form in no way obligates me to perform any volunteer service.
• BBBSF is not obligated to match me with a youth. As part of the enrollment process, additional personal information may need to be provided prior to making any recommendations for assignment.
• All records and information gathered are the property of BBBSF.
• BBBSF has the right to discontinue the application process at any time and can close my match to a Little Brother or Little Sister at agency discretion.
• BBBSF does not discriminate nor will it support organizations that discriminate on any basis including age, gender, race, ethnicity, national origin, sexual orientation, physical or mental ability, political affiliation, or religious belief and values
• Other BBBSF agencies or youth organizations where I have worked or volunteered may be contacted as references
By clicking the "Submit" button you agree to all terms and conditions listed in the above agreement