Enroll a Child Interest Form
Please complete all the fields with the parent or legal guardian's contact information and submit the request below. A representative from the agency will contact you to begin the enrollment process shortly.
* Asterisk Denotes Required Field
Parent/Guardian's First and Last Name (*)
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Parent/Guardian's Email Address (*)
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Confirm Email Address (*)
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Parent/Guardian's Phone (5555555555) (*)
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Phone Type
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Parent Mailing Address (*)
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Parent Physical Address (If different from mailing)
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Living Situation (*)
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Child 1 Name (*)
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Child 1 Date of Birth (mm/dd/yy) (*)
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Child 1 Gender
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Child 2 Name
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Child 2 Date of Birth (mm/dd/yy)
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Child 2 Gender
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Child 3 Name
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Child 3 Date of Birth (mm/dd/yy)
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Child 3 Gender
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Child 4 Name
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Child 4 Date of Birth (mm/dd/yy)
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Child 4 Gender
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Parent/Guardian Relationship to Child/Children (*)
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I understand that:

• This interest form in no way obligates my child to participate in a mentoring program.

• BBBSF is not obligated to match my child with a volunteer. 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 child’s match to a Big Brother or Big 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

By clicking the "Submit" button you agree to all terms and conditions listed in the above agreement
Submit Interest Form:

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