Big Brothers Big Sisters of the Bay Area En EspañolContact UsHome

 

Step 1 of 2
Enroll Your Child – There's only 2 steps

Child's Information

I am Interested in the following program for the child:
  • No Preference — You can choose later.
  • Community-Based Program — what's this?
  • Site-Based Program — what's this?
  • Mentoring Children of Prisoners Program — what's this?
• Child's First Name:
 		 • Child's Last Name:
 
• Child's Gender:
Male Female 		• Child's Date of Birth (## / ## / ####):
• Child's Ethnicity/Race:

Your Contact Information
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 #:
() -

Parent / Guardian's Contact Information

• First Name:
 		 • Last Name:
 
Relationship to the Child:
 • Email:
Address:
 Apt. #:
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

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

Address:
 Apt. #:
City: 
 State:
 Zip:
Phone #:
() -

Emergency Contact — (Other than Parent) Required

• First Name:
 		 • Last Name:
 
• Email:
 • Phone #:
() -
• Relationship:
  

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

Parent in prison:
Mother Father		 Type of prison:
Local State Federal