Loyola University Big Brothers Big Sisters Program application

Before you complete the application, please check the Selection Criteria page to make sure that you are eligible to participate.

Contact Information

First Name: *

Last Name: *

E-mail Address: *

Local Phone:

Cell Phone:

Holiday/Permanent Phone :

Campus Address:

Permanent Address:

Emergency Contact Person:

Emergency Phone Number :

Personal Information

Are you a new or returning mentor? : *

New applicant

Returning mentor

School:

University Status: *

Expected Graduation date:

Students only

Gender: *

Male

Female

Date of Birth: *

Ethnic Background:

Voluntary - will be used in a nondiscriminatory manner, consistent with applicable civil rights laws

If other ethnic background, please specify:

References

Reference 1: Name: *

Reference 1: Phone Number: *

Reference 2: Name: *

Reference 2: Phone Number: *

I hereby give permission to Big Brothers/ Big Sisters of South East LA to call the references given above to determine whether I would be a suitable mentor in the Big Brothers/Big Sisters program and to screen me for criminal offenses. I understand that completing this application does not guarantee I will be accepted into the program. I understand that not every volunteer accessing the Big Brothers/ Big Sisters program is accepted and that reasons for non-acceptance are never disclosed.

Loyola University New Orleans

Community Service - Office of Mission + Ministry

Loyola University Big Brothers Big Sisters Program application