Bellefaire JCB

Bellefaire JCB

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Volunteer Application

required field = Required

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.

 Personal Information

Full Name (first, last): required field  
Birth Date
required field
Email required field
Marital Status
Home Address required field
City required field
State required field
Zip Code required field  
Religion }  
Race
   
Home Phone  required field  
Cell Phone  

Employment Information

Employer required field
Job Title
Work Phone required field
Email Address required field

Education
High School
College
Location
Location
Dates Attended
Dates Attended
Degree
Degree
Extra Curricular Activities
Extra Curricular Activities
PostGraduate/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 have more than 4 points on driver's license.

Driver's License Number
Insurance Carrier

References

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.

Name 1
Relationship
Day Phone
Home Address
City
State
Zip Code

Name 2

Relationship
Day Phone
Home Address
City
State
Zip Code

Name 3

Relationship
Day Phone
Home Address
City
State
Zip Code

Spouse or Significant Other

Relationship
Day Phone
Home Address
City
State
Zip Code

Applicant's Statement

required field  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.

 

 

Bellefaire JCB
Bellefaire JCB

Bellefaire JCB • 22001 Fairmount Boulevard • Shaker Heights, OH 44118 • Phone: 216 932-2800 • All Rights Reserved • Copyright ©2008

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