Please type or print information requested for four references:
1) Your Employer, or if you are a student, a teacher or counselor;
2) If you have volunteered for a youth serving organization, a supervisor;
3) Friend; and
4) Your spouse/partner, or if single, other relative.

I understand that:

  • The references I listed may be contacted by mail, telephone or e-mail;
  • I am in no way obligated to perform any volunteer services;
  • The information I provided may be used to conduct a background check, to include driving records check, criminal background check, and other records where required by local, state, or federal law for volunteers working with youth;
  • The BBBS agency is not obligated to match me with a youth;
  • Other BBBS agencies or youth organizations where I have worked or volunteered may be contacted as references; and,
  • As part of our enrollment process, we will be asking you to provide additional personal information prior to making any recommendations for assignment.

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    Check all interests that apply


    Reference 1 - Spouse/Partner or Other Family Member

    Reference 2 - Employer, Co-Worker or School Personnel

    Reference 3 - Friend, neighbor or other personal reference