Community Based Parent/Youth Application
Thank you for your interest in enrolling a child! Please complete the application as detailed as possible. Once you submit the application, you will receive an email from the agency. The email will have our orientation attached that is required to review for enrollment.

Once we get confirmation that the orientation is complete we will contact you to schedule in-person interview with you and your child.

All applications will be given equal consideration regardless of race, sex, disability, marital status, sexual orientation, religion, or national origin.
Parent/Guardian Name *
First and last name
Your Relationship to the Child *
Child's Name *
First and last name
Do you have legal custody of the child? *
Is there a person who shares legal custody of this child? *
If answered yes to the above, are they aware and supportive of the child's enrollment in BBBS? Please provide their name, address, and phone number.
Child's Gender *
Child's Pronouns
Child Date of Birth *
MM
/
DD
/
YYYY
What is the child's living situation? *
Required
Email *
Phone number *
Can we text this number? *
Address *
Street, City, State, Zip
Please list all adults and children living in the household - Include their names, age, and relation to the child. *
Is parent/guardian receiving income assistance at this time? *
Is parent/guardian receiving assistance with housing (e.g. Section 8, residence in public-housing, etc.)? *
Is child eligible for free or reduced lunch? *
Household Annual Income: (total income of the adults the child lives with) *
Does your child have a parent/caregiver with current or past military experience? *
If yes to the question above, please state who the parent/caregiver is and list dates of service
Does the child have a parent/guardian who is currently incarcerated? If yes, please explain. *
Child's School and Grade *
Within the last year, has child been in trouble at school? *
Please check all that apply.
Required
Race/Ethniciy *
Check all that apply
Required
Parent/Guardian Place of Employment *
May we contact you at work? *
If we are unable to reach you, who is someone we could call who always knows how to reach you? Please include Name & Phone #
What is the primary reason for wanting your child to have a Big Brother or Big Sister? *
Does your child know that you are applying for this program? *
Does your child want to participate in the BBBS Program? *
Where did you hear about Big Brothers Big Sisters? *
Please check all that apply
Required
Does your child have siblings or relatives who are applying for the BBBS Program at this time or who are currently in the program? If yes, please provide their name. *
Do you plan on moving out of Marquette/Alger County in the next year or two? If yes, please explain. *
Will your child be able to meet with their Big Brother/Big Sister for a minimum of 4-6 hours a month for one-year commitment? *
Does your child have any medical conditions that might affect them from participating in activities with their Big Brother/Big Sister? If yes, please explain. *
Has child ever been arrested or involved in the juvenile justice system? If yes, please explain. *
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