Volunteer Questionnaire

Thank you for choosing to learn about the possibility of volunteering as a mentor with Big Brothers Big Sisters of Tampa Bay. Our mission is to provide children facing adversity with strong and enduring professionally supported one-to-one relationships that change their lives for the better, forever.

Which program is right for you?

Community-Based Mentors commit to spending an average of 8 hours a month for at least 15 months from the time they are matched with a mentee. Community-Based Mentors coordinate one-to-one outings in the community with their mentee by communicating with the mentee’s parent/guardian.

Site-Based Mentors commit to visiting for 1 hour a week at the child’s school/afterschool site for at least 12 months. Site-Based Mentors spend one-to-one time with their mentee at the child’s school or afterschool site only.

Volunteer Eligibility Policy
To be a volunteer mentor with Big Brothers Big Sisters of Tampa Bay’s programs, participants must:
• Be at least 18 years of age for the Community Based program, and be at least 14 years of age and a sophomore in high school for the School/Site Based program, with parental consent and an assurance of reliable transportation;
• Be a resident, employed, or a student in Hillsborough, Pinellas, Polk, Pasco, Citrus, Hernando, or Sumter County;
• Must be a resident within our service area for a minimum of 3 months;
• Community Based - have regular access to an automobile, current automobile insurance, an acceptable driving record, and a valid driver’s license, and not have been convicted of a DUI within the past five years;
• Pass a Level-2 background screening; and
• no disqualifying criminal history;
• have support of spouse, family or significant other;
• Must not be involved in any illegal activity, including drug use; must not have been convicted of a felony within the last ten (10) years; felony convictions that are more than ten (10) years old or misdemeanor convictions will be considered on a case-by-case basis.

Help us get to know you. The information you provide will help us make a better match for you and assure we can support your involvement with our program.

Name*

First Last

Email*

Do you have any concerns about your ability to fulfill the 15-month commitment required for community-based mentors or the 12-month commitment required for site-based mentors?*

Yes
No

If yes, please explain

Community-based mentors are required to use their personal vehicles to provide transportation during outings with their mentees and they are not compensated for travel costs. If applying to be a community-based mentor, are you comfortable with using your personal vehicle for transportation during outings.*

Yes
No

If no, please explain

Do you have children living at home?*

Yes
No

How will they feel about you spending one-to-one time with another child?

Do you have guns, ammunition, or other weapons in your house?*

Yes
No

If you are applying for site-based, do you have the availability to mentor 1 hour a week (Monday-Friday)?*

Please note, we do our best to make new site-based matches between September and April each year. Site-Based mentors applying in the spring may not be matched until September.

Yes
No

Life Changes

Have you had any of the following life changes in the past year, or do you expect any of the following life changes within the next year?

*All life changes will be discussed during the interview.

Marriage, Divorce or Separation from Spouse/Significant Other*

Yes
No

Pregnancy or Adoption or Fostering a Child(ren)*

Yes
No

Change in Health of Family Member that you care for*

Yes
No

Gain of a Family Member that you care for*

Yes
No

Child Leaving Home*

Yes
No

Personal Injury or Illness*

Yes
No

Death of Spouse, Significant Other, or Other Family Member*

Yes
No

Change in Residence in Last 6 Months*

Yes
No

Moved more than once in the last 3 years*

Yes
No

Change in Employment/Retirement*

Yes
No

Anticipating Promotion / Possible Relocation / Looking for a New Job*

Yes
No

Change in Responsibilities at Work*

Yes
No

Change in Work Schedule/Hours*

Yes
No

Hold more than one job*

Yes
No

Not available on weekends*

Yes
No

Change in Schools*

Yes
No

About to Begin or End School*

Yes
No

Lived in Area for At Least 3 Months (Includes: Hillsborough, Pinellas, Polk, Pasco, Citrus, Hernando, Sumter, Alachua, and Marion County)*

Yes
No

Referral

We’re always looking for volunteers! Do you have any friends or family members that you’d like to refer to us? We’d be happy to reach out!

Name

First Last

Phone

Email

Name

First Last

Phone

Email

Volunteer Pre-Interview Questionnaire

Life Changes

Referral

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