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Volunteer Application for Big Brothers & Sisters of Green Country, Inc. - Tulsa

This information is being sent via a secure form.

Please note: you must be at least 18 years of age to be a Big.

Program

Please select the program for which you are applying:
Traditional Core Program School-based Program
 Big Brother
 Big Sister
 Couples Match
 Big Brother
 Big Sister
General Information
First Name
Middle Initial
Last Name
Maiden Name
Date of Birth
Gender  Male    Female
Race
SSN Number
Driver's License
Home Address

include Address, City, State, Zip

Mailing Address

include Address, City, State, Zip

Home Phone
Work Phone
Cell Phone
Marital Staus
Employer
E-mail Address
Referred By
For Couples Only
Spouse's Name
SSN Number
Home Phone
Work Phone
Date of Birth
Gender  Male    Female
Employer
References
It is advisable that you inform your references that we will be contacting them and encourage their prompt reply so as not to delay your application.
Immediate
Supervisor

 Name
Street Address, City, State, Zip
 Home Phone
 Work Phone

 

Please list the names and addresses of two persons who have known you well for at least two years whom we may contact for a personal reference. DO NOT LIST RELATIVES.  Please give complete mailing addresses and phone numbers.

Personal #1

 Name
Street Address, City, State, Zip
 Home Phone
 Work Phone

 

Personal #2

 Name
Street Address, City, State, Zip
 Home Phone
 Work Phone

 

For Couples Only - References

Spouse
Immediate
Supervisor

 Name
Street Address, City, State, Zip
 Home Phone
 Work Phone

 

Spouse
Personal

 Name
Street Address, City, State, Zip
 Home Phone
 Work Phone

 

Couples references must be someone who knows both applicants as a couple.

Couples #1

 Name
Street Address, City, State, Zip
 Home Phone
 Work Phone
 

Couples #2

 Name
Street Address, City, State, Zip
 Home Phone
 Work Phone

 

By submitting this form, you authorize Big Brothers & Sisters of Green Country, Inc. to secure any information from medical, employment, educational, law enforcement or any other sources the agency deems necessary to evaluate your potential as a Big Brother or Big Sister. All records and information gathered are the property of Big Brothers & Sisters of Green Country, Inc. Applicants shall not have access to such information except as authorized by agency policy and procedure.