New Mentor App Test BBBSPY Mentor Application Form (R. Aug 2024) "*" indicates required fields Step 1 of 7 14% This Form Will Take You Roughly 30-45 Minutes To Complete & Require You to Upload a Photo IDThe Mentor Application Form will take between 30-45 minutes to complete. In order to keep the information private and secure this application must be completed all at once and cannot be saved in stages. Please make sure you have enough time before starting the application. You are also required to upload a copy of your photo idea, please be sure to have that handy before beginning the application. Thank you!Mentor Eligibility CriteriaBefore completing the application please review and complete the following checklist:*Each box must be checked in order for your application to be considered complete. I am at least 18 years old. I am a resident of Peel Region, York Region or Bradford West Gwillimbury. I understand that I am expected to provide one piece of Photo ID for application verification (ex. driver’s license, age of majority card, student ID). I understand that the time between application and program involvement could be between 3-6 months. I understand that I am expected to commit for a minimum of one year for program involvement. I understand the enrolment process includes a Vulnerable Sector Check, which has a cost of approximately $32 to be paid by me. I understand that Big Brothers Big Sisters of Peel York is under no obligation to approve my application. I understand that if I am not accepted as a Mentor, I will not be provided with a reason why. I understand that BBBSPY is committed to creating an inclusive environment where all members of the community feel safe and respected. As a volunteer Mentor, I will actively work towards supporting this commitment. Volunteer Mentor ApplicationPlease note that the information provided in this application will be held strictly confidential. PLEASE ENSURE THE APPLICATION IS COMPLETED IN FULL.How did you hear about our agency?*Brochure/PosterBusiness/CorporatePost-Secondary PresentationFormerly a BigFormerly a LittleReferred by a FriendInformation BoothEventRadioRoad SignSocial MediaNewspaperTelevisionWebsiteWord of MouthAlways KnownPlease select the program you are MOST interested in:*To help you make this decision please review the OUR PROGRAMS tab on our website. Big Brothers BCAC Big Brothers (Available to Mentors and Mentees from the Black Community) Big Sisters BCAC Big Sisters (Available to Mentors and Mentees from the Black Community) Big Buddy (Female Mentors matched with Male Mentees) In-School Mentoring Group Mentoring Go Girls! Game On! Conversation Club (Supporting Newcomer Youth)) If you are interested in more than one Program, please select the others here: Big Brothers BCAC Big Brothers Big Sisters BCAC Big Sisters Big Buddy In-School Mentoring Group Mentoring Go Girls! Game On! Conversation Club PERSONAL INFORMATIONName* First Last Preferred Name (if applicable) Gender Identity* Pronouns Street Address* Address Line 2 City* Province / Territory*ONABBCMBNBNLNTNSNUPEQCSKYTPostal Code* Country* Length of time at this address* Phone*Email* Date of Birth* MM slash DD slash YYYY BBBSPY requires a copy of photo identification (ex. driver's license, age of majority card, identification, etc.)*Please upload a clear photo or scanned copy of your ID here. Drop files here or Select files Max. file size: 100 MB. Language(s) Fluently Spoken* Are you anticipating any major changes in your life within the next 18 months?*E.g. marital status, living arrangements, employment, children, etc. Yes No If Yes, please specify. Marital Status*SingleMarriedDatingDivorcedWidowedCommon LawSeparatedN/APartner/Spouse Name (if applicable) Do you have or have you had any physical or emotional health concerns?* Yes No If Yes, please describe.Have you ever had police involvement?* Yes No If Yes, please provide brief details. VEHICLE INFORMATIONWhat type of driver's license do you have?*A G2 license is required for individuals applying for the Big Brother, Big Sister, and Big Buddy programs. No license G1 license G2 license G license or above Do you have access to a vehicle?* Yes No Please select your current vehicle insurance coverage* $1million $2million I do not have vehicle insurance EDUCATION INFORMATIONAre you currently attending school?* Yes No If Yes, please list the name of the school Please list your area of study Highest level of education completed*College DiplomaHigh SchoolMastersPhDSome Post SecondaryUniversity DegreeVocational TrainingBachelor of Education (Elementary Education)Please list any degrees, diplomas, and/or training EMPLOYMENT INFORMATIONAre you currently employed?* Yes No If Yes, please list your employer What is your current job title? RELEVANT EXPERIENCEHave you had any volunteer or work experience with children and youth?* Yes No If Yes, what is the name of the organization? Please list and describe any relevant volunteer or paid experiences with children or youth such as your role, what it involved, and when it was.Have you ever applied to a Big Brothers Big Sisters agency before?* Yes No MOTIVATIONWhy do you want to be a volunteer with Big Brothers Big Sisters of Peel York?*Will volunteering with Big Brothers Big Sisters of Peel York assist in career or vocational aspirations?* Yes No If Yes, please explain.Describe the ideal child/youth for you to mentor.*VOLUNTEER LOCATIONS AND AVAILABILITYPlease select the locations where you are willing and able to volunteer.*Please select all that apply. Aurora Bradford Brampton Caledon Caledon East East Gwillimbury Georgina Keswick Markham Mississauga Newmarket Richmond Hill Stouffville Thornhill Vaughan What time of day are you available to volunteer?*Please select all that apply. During the school day After school Weekday evenings Weekends How often are you able to mentor?* Weekly Bi-weekly Please share any additional scheduling comments hereAPPLICATION ATTESTATIONI hereby confirm that I am the individual for whom this application is being made. I further attest that the information provided here is true and complete to the best of my knowledge.* Yes No Signature* Before continuing, please ensure that your references know you have applied and ask them to watch for a reference email from our Agency. Also, please ensure that the email addresses of your references are spelled correctly below. Moving to the next steps in the enrolment process is contingent upon the completion of your references. PERSONAL REFERENCEExamples include a friend, family friend, coworker, etc. Must have known you for at least 2 years and be 18+Personal Reference Full Name* Personal Reference Email* Personal Reference Phone*How long have you known your Personal Reference?* In what capacity do you know your Personal Reference?* VULNERABLE SECTOR REFERENCEPlease provide a reference from your past volunteer or work experience with an organization responsible for the well-being of vulnerable persons. This may include: children/youth under the age of 18, the elderly, and/or those with disabilities. If you have not had experience in the vulnerable sector, please provide an employment reference. Must be 18+Vulnerable Sector or Employer Reference Full Name* Vulnerable Sector or Employer Reference Email* Vulnerable Sector or Employer Reference Phone*How long have you known your Vulnerable Sector or Employer Reference?* In what capacity do you know your Vulnerable Sector or Employer Reference?* FAMILY REFERENCEExamples include parent/guardian, sibling, aunt, etc. Must have known you for at least 2 years and be 18+Family Reference Full Name* Family Reference Email* Family Reference Phone*How long have you known your Family Reference?* In what capacity do you know your Family Reference?* SIGNIFICANT OTHER REFERENCE (IF APPLICABLE)Any current relationship lasting 3 months or longer and/or a cohabiting relationship of any length of time must be noted here.Significant Other Full Name Significant Other Email Significant Other PhoneHow long have you known your Significant Other? Please briefly describe the nature of your relationship OPTIONAL: Social Identity DataAt Big Brothers Big Sisters of Peel York, statistical information is requested from volunteers and families for the purpose of better understanding the community in which we serve, and for acquiring funding from community supporters and donors. This allows us to provide high-quality services at no cost. Please note: Filling out this document is completely optional and voluntary. If you choose to complete it, the information you provide will be kept confidential and will in no way affect your participation with our Agency. Big Brothers Big Sisters of Peel York is committed to ensuring that our programs and services are responsive and accessible to diverse populations across the regions we serve. Information collected through the Social Identity Date tool is used to identify trends and gaps in our service delivery. We appreciate your support and participation in ensuring that we are an inclusive organization. Thank you.Birth Place Canada Other If you were born outside of Canada, please indicate the year you moved to Canada Please select the ethnic/cultural origin that you feel best describes you, or use the next field to enter it directly.Prefer not to sayAsian – East (e.g., Chinese, Japanese, Korean descent)Asian – South (e.g., Indian, Pakistani, Sri Lankan descent)Asian – South East (e.g., Malaysian, Filipino, Vietnamese descent)Black – African (e.g., Ghanaian, Kenyan, Somali descent)Black – Caribbean (e.g., Barbadian, Jamaican descent)Black – North American (e.g., Canadian, American descent)First NationsIndian – Caribbean (e.g., Guyanese with origins in India)InuitLatin American (e.g., Argentinean, Chilean, Salvadorian descent)MétisMiddle Eastern (e.g., Egyptian, Iranian, Lebanese descent)White – European (e.g. English, German, Italian descent)White – Middle EasternWhite – North American (e.g. Canadian, American)If none of the options above accurately reflect your identity, please feel free to add a note here: What is your total annual household income?Prefer not to answerBelow $10,000$10,001 – $20,000$20,001 – $30,000$30,001 – $50,000$50,001 – $75,000over $75,000FINAL ATTESTATIONFor the purpose of considering my Mentor Application, a) I consent to Big Brothers Big Sisters of Peel York contacting the references, in confidence, included in my Mentor Application and I hereby waive the right to request disclosure of the references given about me. b) I consent to Big Brothers Big Sisters of Peel York 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. I hereby confirm that I am the individual for whom this application is being made. I further attest that the information provided here is true and complete to the best of my knowledge. 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 Peel York and subsequently Big Brothers BigSisters of Canada.* Yes No Signature*PhoneThis field is for validation purposes and should be left unchanged. Facebook Twitter Google+ LinkedIn