enroll « Big Brothers Big Sisters of the Bay Area

Step 1 of 2

Enroll Your Child – There’s only 2 steps

Child’s Information

Parent / Guardian’s Contact Information

• First Name:	• Last Name:
• Relationship to the Child:	• Email:
• Address:	• City:	• State:	• Zip:
At least 1 phone # is required; Home, Cell or Work.
Home Phone:	Cell Phone:
Work Phone:	How did you hear about Big Brothers Big Sisters?:
Preferred Phone: Home Work Cell	Best Time to Call: Morning Noon Night
Please fill out the following section if you are not the child’s legal guardian
Your First Name:	Your Last Name:
Your Relationship to the Child:	Email:
Best Phone # to Contact You at:	Phone #:

Child’s Residence
Please fill this section out if the child’s residence is different than their guardian’s

Address:	City:	State:	Zip:
Phone #:

Parent in Prison
Please fill this section out if the child has a parent in prison.

• Parent in prison:
Yes No

If yes, in County Jail?
Yes No

If yes to previous question, is there a Prison Sentence Pending?
Yes No

Which parent?

Emergency Contact — (Other than Parent) Required

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