Note: ALL Fields Required* ('NA' for Blanks)
Full Legal Name:*
Date of Birth:*
Driver's License Number:*
Preferred Phone Number (one required): Home Mobile Work:
If married, Spouse's Name:
Number of Children:
Your Children's Sex & Age:
Your best contact days
Sun Mon Tue Wed Thu Fri Sat
Your best contact times
Your Employment Information
Contact you at work?
Position / Title:*
Your Education History
Highest grade completed:*
Elementary High School Technical School College
Degree / Other specialized training:
Other Volunteer Experience
Previous experience with Children?
Please describe (Babysitting, Church, Girl Scouts, etc.) length of time worked and age group:
Do you have any physical or mental conditions that would require special accommodations for your volunteer service? If yes, please describe:
Times when you are most available for mentoring activities:
Are you away during parts of the year? Please describe:
Please list your special interests to share with a young girl:
If yes, what type?
OK with children?
Please explain why you would like to be matched with a Little Sister:
Preferred age level (Low to High):
Any other preferences:
Can commit to one year with program?
Available 2x month for Little Sister?
How were you referred to Big Sisters of Greater Racine, Inc?
Please describe a brief history of yourself. Include information about any meaningful events in your life as you were growing up:
Reference's Full Name:*