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Big Brothers Big Sisters
of Greater Nashua

Application to become a
Big Brother or Big Sister
Nashua: 603-883-4851 / Derry: 603-434-4414
toll-free: 888-412-BIGS (2447)


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Opportunities

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Please complete the following application
by responding to all the questions.

This information is kept strictly confidential.

 

APPLICANT

Full name
(first, middle, last)
Home address
(street, city, state, zip)

Length of Residency in NH years or months

Home phone  
Email
Education level
Date of Birth Gender Female Male
Marital Status
Ethnicity
   
Possession of a driver's license is not a requirement to participate in any of our programs but is required if you will be transporting a youth in any vehicle you are operating. 
Do you have a
driver's license?		   Yes    No
If yes: State of issue Expiration date
  License #
Employment  
Employer
Work address
(street, city, state, zip)
Work Phone   Fax
May we contact you at work? Yes    No
Occupation
Work Hours
How many years employed


REFERENCES
Please provide complete information for three references

1) Your current or past employer who has known you for at least one year

Employer's name
(or parent's name, if student)
Supervisor's name
Address
(street, city, state, zip)
Day Phone
Fax #
Email

2) A co-worker or friend who has known you for at least 2 years
(or teacher, if a student)

Co-Worker / Friend / Teacher name
Address
(street, city, state, zip)
Day Phone
Fax #
Email

3) A close family member (spouse/domestic partner)
or a second friend who has known you for at least 3 years

Family member /
friend name
Address
(street, city, state, zip)
Day Phone
Fax #
Email

Have you ever applied before to be a Big Brother or Big Sister?

Yes    No
If yes: Where did you apply?
          When?   

At this time, which of our programs are you most interested in?

Community-based  School-based  After-School Programs

By submitting this application, I indicate my agreement that...

The references I listed may be contacted by mail, telephone, or email; this application in no ways obligates me to perform any volunteer services;
The information I provide may be used to conduct a background check, to include driving records check, criminal background check, and other records required by local, state, or federal law for volunteers working with youth;
BBBS of Greater Nashua, Inc. is not obligated to match me with a youth; As part of the enrollment process, I will be asked to provide additional personal information prior to BBBS making any recommendations for assignment.

For more information on becoming a Big Brother or Big Sister, email us or call 603-883-4851 (Nashua) or 603-434-4414 (Derry).

Big Brothers Big Sisters of Greater Nashua serves children in Amherst, Brookline, Derry, Hollis, Hudson, Litchfield, Londonderry, Merrimack, Milford, Mont Vernon, Nashua and Wilton

~~~~~~~~~~~~

Send email to
bbbs@bbbsnashua.org

33 Main Street, Suite 501
Nashua, NH 03064