Youth Referral Form

Note to Referring Workers: Please have the Parent/Guardian of the youth you are referring to the 1:1 Mentoring Program read this letter and sign in the space indicated on page 13.

Dear Parent/Guardian,

Thank you for your interest in the 1:1 Mentoring Program! The 1:1 Mentoring Program matches Lower Mainland girls, non-binary, transgender and gender-diverse youth (aged 7-17) with a volunteer mentor in a one-to-one mentoring relationship.

Our volunteer mentors are 19 years or older and undergo a criminal record check, in addition to providing references. They receive training in child safety, adhering to National Standards, and are screened and monitored by our professional staff. The staff offers support, care, and mandatory check-ins for the caregiver, youth, and mentor throughout their involvement with the program.

Before you fill out this referral form, please:

Make sure your youth meets the criteria to be in the 1:1 Mentoring program. YES, they are:

• ✓ Between the ages of 7 and 17
• ✓ A Lower Mainland resident (Vancouver, Richmond, North/West Vancouver, Burnaby, Coquitlam, Port Coquitlam, Port Moody, New Westminster, Surrey/White Rock, Delta, Tsawwassen, Ladner)
• ✓ Interested in being matched with a caring, adult mentor
• ✓ Able to meet the minimum time commitment (2-4 hours once a week for a minimum of one year for Big Sisters program, one hour once a week for a minimum of six months for Study Buddy program)

Make sure you meet the criteria for your youth to be a Mentee in the 1:1 Mentoring Program. YES, I am:

• ✓ Supportive of and interested in my youth being involved in this program
• ✓ Able to ensure my youth meets the minimum time commitment
• ✓ Able to meet my responsibility of maintaining regular contact and participation with the Big Sisters agency
• ✓ Aware that the matching process can take approximately 6 to 12 months before my youth can be paired with a mentor

Please refer to page 5 of this form for submission options, then fill out and submit the form accordingly.

Thank you for your interest in Big Sisters — we look forward to meeting you!

Thank you for your interest in referring a youth to our program!

We offer supportive mentoring relationships for youth (aged 7–17) who identify as female, non-binary, two-spirit, transgender, and gender-diverse through our mentoring programs. Our service areas include North and West Vancouver, Vancouver, Burnaby, New Westminster, Delta, Richmond, Tri-Cities, Surrey, White Rock, Tsawwassen, and Ladner. There are two one-to-one mentoring programs available: Big Sisters and Study Buddy.

Big Sisters Program:

This program supports youth to improve their self-confidence and self-esteem by working with a trusted adult Mentor in a 1:1 mentoring relationship. Mentor and Mentee match meets for 2-4 hours, once a week for a one-year commitment, enjoying fun activities like crafting, attending events, or simply spending time talking.

Study Buddy Program:

This program provides youth with an academic role model to improve their school performance and reach educational goals. Mentors and youth meet for one hour each week at a mutually convenient location, such as a library, for at least six months.

We kindly ask that the legal guardian review the information and confirm their understanding of both the program commitments and the current wait time listed on the following pages.

Please note: Due to high demand and capacity, our waitlist is approximately 1 year (or longer in some cases) before a youth can be matched in our programs.

General FAQs:

How long will it take for a youth to be matched with a Volunteer Mentor?

• Our current waitlist is approximately 1 year
• Longer wait times are in Surrey, Tri-Cities and Richmond due to fewer volunteers
• Longer wait times for Mentees:
  • Big Sisters Program: limited scheduling availability can increase the wait times
  • Study Buddy Program: needing support with high school math and sciences due to limited volunteers who can provide support in these specialized areas

Who is a Volunteer Mentor?

• Self-identified women or gender diverse individuals aged 19 or older.
• Before volunteering, Mentors provide strong references, complete a criminal record check, and undergo a thorough screening process. They demonstrate the maturity, responsibility, and commitment needed to build a meaningful relationship with a young person.
• They also receive extensive training and on-going support from qualified professional staff throughout their relationship with their Mentee.
• Big Sisters Program: they are willing to commit to spending 2-4 hours, once a week, for a minimum of one year with their Mentee. They may have any type of job or may be a student at a local college or university.
• Study Buddy Program: they are willing to commit to spending 1 hour once a week, for a minimum of six months with their Mentee. Can be a student, a working professional, a parent, retired etc. (Our Study Buddy Mentors are not professional tutors).
• Overall, a Mentor is a stable and positive role model outside the family circle, that your youth can enjoy spending time with and creating a lasting and meaningful friendship.

 What is the intake process for youth?

• The intake conversation helps us understand the youth’s support needs, interests, goals and personality to make the most compatible match with a Mentor. (It may take 3-6 months for the Mentoring Coordinator to reach out)
• Parent, Guardian or Referring Agent will complete and submit a referral form to provide background information about the youth. The referral form must be signed by the legal guardian.
• A Mentoring Coordinator will reach out to the legal guardian to schedule an in-person intake conversation with the youth and Parent/Guardian which includes mandatory Child Safety Training (approx. 1.5-2 hours).
• The goal of Child Safety Training is to increase the safety and well-being of all Mentees throughout their mentoring relationship and beyond.
• Our team will review the information above and determine if our programs are the best fit for the youth at this time.

What is the commitment for our programs?

• Big Sisters Program: 2-4 hours per week for a minimum of one year
• Study Buddy Program: 1 hour per week for a minimum of six months
• Parents/Guardians are responsible for setting up weekly meetings with the input of the Mentee and Mentor
• Parent/Guardian, Mentee and Mentor will have regular scheduled mandatory check-ins with their Mentoring Coordinator by phone call, through virtual platform or in-person.
• Missing a mandatory check-in may be grounds for closing the match
• Communication between all match members (Mentor, Mentee, Parent/Guardian & Mentoring Coordinator) is essential

Once the legal guardian has confirmed their understanding, please complete the referral form. When completing the referral form, please only select one program; however, we are happy to support a transition in the future if the youth’s needs or interests change.

Kindly ensure that all required pages are completed and signed by the legal guardian to avoid any delays in processing.

You can submit the referral form electronically from this page, or you can fill out and submit the PDF version.

To submit the electronic version of the form, please click the "Next" button below.

To submit the PDF version of the form, click here to download the form.

We truly appreciate your interest in Big Sisters of BC Lower Mainland, and we look forward to hearing from you.

Once your referral form has been processed, you will receive an Acknowledgement Letter. It may take 3-6 months before we contact you to schedule an intake conversation.

If you have any questions about the referral process or our programs, please feel free to contact a member of our team at info@bigsisters.bc.ca or 604-873-4525 ext. 101.

PLEASE NOTE:

(1.) Mentors are community volunteers who agree to spend quality time with a youth. They do not have specialized training to deal with some complex issues faced by youth. A Mentoring Coordinator will phone you to determine if the Big Sisters Program is appropriate for the youth as we are not able to find suitable matches for all youth who are referred.

(2.) Our waitlist depends on a variety of factors such as where the youth lives, their interests and the volunteers available, and so it may take 6 to 12 months before the youth is matched with a Mentor.

I hereby make formal application to Big Sisters of BC Lower Mainland (“Agency”) to make available their service to my child. It is my understanding that the intention of the Agency is to match a responsible, adult volunteer (minimum age 19) with my child for the purposes of shared activities, friendship and support. I understand that all efforts will be made to select a volunteer mentor who is compatible with my child.

In consideration for this service and other valuable consideration provided to my child by Big Sisters of BC Lower Mainland, I release the agency of all responsibilities and liabilities in connection to their services provided in good faith, to myself or my child. I permit the Agency to release any relevant information, including my personal information, to Big Brothers Big Sisters of Canada and their insurers, as may be appropriate in connection with any legal proceeding, inquiry or risk thereof.

I consent to Big Sisters of BC Lower Mainland contacting any referring professionals involved with my family to obtain information for the purposes of assessing my application for a Mentor for my child. I further agree that all or part of the information herein may be shared, at the discretion of Big Sisters of BC Lower Mainland, with my child’s mentor and/or with the referring professional, so that my child’s needs in a mentoring relationship may be best met. I understand that the collection of personal information about me or my child will be held in strict confidence and is to be used solely for the purposes of administering the program.

I understand that I am under no obligation to accept a mentor for my child, that the Agency is under no obligation to provide my child with a mentor, and that this application is the property of Big Sisters of BC Lower Mainland. I also agree that I and my child will participate in the Pre Match Training Program administered by Big Sisters of BC Lower Mainland.

hereby request Big Sisters of BC Lower Mainland’s service for my child. I give the agency my consent to assign a mentor to my child. I am aware of and understand the risks, dangers and hazards associated with the above service and agree such service is suitable for my child.

I hereby consent to Big Brothers Big Sisters of Canada (National Office) and its associated member Big Sisters BC Lower Mainland the use of any photographs, audio and/or video recordings of my child or youth as taken or produced by media personnel and/or National Office or Local Agency staff at recreational events or match outings, or otherwise authorized by the National President & CEO, local agency President/Executive Director/CEO or Board of Directors, and that this media may be used by Local Agency and/or by the National Office for purposes of promotional material including brochures, posters, newsletters, media information, advertisements, audio-visual productions and digital media, (such as the local agency websites and social media). Photographs or video productions may also be shared with community and school partners for program promotion.

In the two sections below, please indicate whether or not you give consent for us to (1) use photos/recordings of your child, and (2) use her first name for publication.