Enrolling a Little into the Program

Matching your child/youth to a caring adult mentor & friend
One day a week, a few hours
(on a schedule that works best for you)

Becoming a Little Brother or Sister
- Little Brothers / Little Sisters are children living in Santa Cruz County that will benefit from a one-to-one relationship with a positive adult friend / role model.
- All Little Brothers / Sisters need and want the friendship of an adult to have fun and help them through difficult childhood experiences.


Requirements
- A desire by the both guardian and child to be a part of the program
- Child age 7-14 years old (or about to turn 7 years old)
- Living in Santa Cruz County


How to Apply
- Fill out an online application in English (below) or Spanish (here)
- Download the application here to print and send to us by mail
- Call the agency at 831-464-8691 or email carrie@santacruzmentor.org to receive an application by mail


Program Details
Like our Little Brothers / Sisters, our volunteers come from a wide variety of backgrounds and experiences. They are at least 18 years of age (or 16 if volunteering for the School-Based program) and may be single or married, perhaps even with a family of their own. Big Brothers / Big Sisters make a one-year commitment to spend a few hours a week with their Little Brother / Sister doing fun activities at a time that work for both of them.


All volunteers for this program, like all Big Brothers Big Sisters volunteers, are interviewed, screened, and trained by our professional agency staff.

Changing the way children grow up in Santa Cruz County.
BEING A PART OF THE CHANGE

~ Please fill out the below application ~
or Presione aqui para una aplicacion en Espanol
Once we receive your application, you will be sent a note from the casework staff explaining the next step.
A casework staff will call you to schedule a Home Visit and answer any questions you may have.
Feel free to give us a call at (831) 464-8691 if you have any further questions.
Thanks for your interest!

Little Application
Questions marked by * are required.
1.	Child's name: *
2.	Gender: * Male Female
3.	Date of Birth: *
4.	Age: * -67891011121314
5.	Languages Spoken: *
6.	Ethnicity:
7.	Street Address: *
8.	City / State / Zip: *
9.	Home Phone: *
10.	Cell Phone:
11.	School Name: *
12.	Child's Grade: *
13.	Child's Guardian 1: * Mother Father Grandparent Foster Parent Other
14.	Guardian's Name (and address, if different than the above): *
15.	Guardian's Date of Birth: *
16.	Guardian's Home Phone: *
17.	Guardian's Cell Phone:
18.	Guardian's Email:
19.	Languages Spoken (Guardian): *
20.	Guardian's Ethnicity:
21.	Highest Level of Education Received: * -Elementary SchoolMiddle SchoolHigh SchoolSome CollegeCollegePost-GraduateVocational CertificationOther
22.	Guardian's Employer:
23.	Guardian's Occupation:
24.	Work Address:
25.	Work Phone:
26.	Guardian's Present Marital Status: * Single Married Divorced Widowed
27.	Date of Separation / Divorce or Death (if applicable):
28.	Child's Second Guardian (if applies): Mother Father Grandparent Foster Parent Other
29.	Guardian 2's Name (and address, if different than the above):
30.	Guardian 2's Date of Birth:
31.	Guardian 2's Home Phone:
32.	Guardian 2's Cell Phone:
33.	Guardian 2's Email:
34.	Languages Spoken (Guardian 2):
35.	Guardian 2's Ethnicity:
36.	Highest Level of Education Received (Guardian 2): -Elementary SchoolMiddle SchoolHigh SchoolSome CollegeCollegePost-GraduateVocational CertificationOther
37.	Guardian 2's Employer:
38.	Guardian 2's Occupation:
39.	Guardian 2's Work Address:
40.	Guardian 2's Work Phone:
41.	Guardian 2's Present Marital Status: Single Married Divorced Widowed
42.	Date of Guardian 2's Spouse Separation / Divorce or Death (if applicable):
43.	Name and Address of Absent Parent (if applicable):
44.	Frequency of Contact:
45.	Date of Last Contact:
46.	Have you spoken to the non-custodial parent about this application? Yes No Plan to
47.	Please list all persons living in your home, both children and adults (Name / Sex / Age / Relationship to Child): *
48.	What 3 words would you use to describe your child's temperament / personality? *
49.	Describe your child's school participation (including performance, conduct, attitude): *
50.	Has your child ever received any kind of counseling? * Yes No
51.	If so, when?
52.	Counselor / Therapist Name:
53.	Counselor / Therapist Phone:
54.	Has your child ever been in any kind of institution? If so, when and why:
55.	Please list your child's health problems / allergies, or physical limitations:
56.	What is your child's reaction to the possibility of being matched to a volunteer? *
57.	What do you hope your child will gain from a relationship with a Big Brother or Big Sister? *
58.	How did you hear about this program? or who referred you? *
59.	The following is for funding purposes ONLY and is kept completely confidential (optional). What is your source of income?
60.	Also Confidential and Optional. What is your approximate yearly household income?
61.	Also Confidential and Optional. Please check any benefits you are receiving: Public Assistance Disability Social Security Medical