A program of Bellefaire Jewish Children's Bureau, 22001 Fairmount Boulevard, Shaker Heights, OH 44118  




Volunteer Application

 
Please check area of interest

Volunteer Opportunities

 

Big Brother Big Sister One-to-One Mentor:
Community-based program; matched with one child, from a Jewish single-parent home, recently resettled immigrant family or family with special circumstances, on an individual basis; meet with Little Brother or Little Sister twice a month; minimum one year commitment required; must be 21 years or older.

Bellefaire Buddy Program:
Community-based program; matched with one child, serving the diversified clients of Bellefaire JCB participating in programs including the foster care program or Parents and Children Together (PACT), on an individual basis; meet with Little Brother or Little Sister twice a month; minimum one year commitment required; must be 21 years or older.

 
 
  
Please complete the following information.

Personal Information

 
Title:
 
Name (first, last):
Home Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
    
  
 
    
Birth Date:
Marital Status:
Religion:
Race:
     
    
 
 
      

Employment Information

 
    
Employer:      
Title:
Work Phone:
Email Address:
 
 
 

Education

    
High School:
Location:
Dates Attended:
Degree:
Extra Curricular Activities:

College:

Location:

Dates Attended:
Degree:
Extra Curricular Activities:
Post Graduate/Other
Location:
Dates Attended:
Degree:
Extra Curricular Activities:
 
 

Driving

 
Volunteers must have access to a car, current driver's license, current car insurance and not more than 4 points on driver's license. 
Driver's License No: Insurance Carrier:
 
 
Please list the complete names, addresses, and daytime phone numbers of three non – family members for references. Contact your reference, have them log on to www.jbbbsa.org and click on the reference link to complete a reference form online.  

References

 
Name 1:
Day Phone:
Home Address:
Relationship:
City:
State:
 Zip:
Name 2:
Day Phone:
Home Address:
Relationship:
City:
State:
 Zip:
Name 3:
Day Phone:
Home Address:
Relationship:
City:
State:
 Zip:
Spouse/Significant Other
Day Phone:
Home Address:
Relationship:
City:
State:
 Zip:
 
 

Applicant's Statement

 
By checking this box, I certify that answers given herein are true and complete to the best of my knowledge. I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination if I am accepted as a Big Brother/Big Sister, whenever it may be discovered. If I am accepted, I understand that I am required to abide by all rules and regulations of The Jewish Big Brother Big Sister Association and Bellefaire Jewish Children's Bureau.
 
 

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