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Enroll a Child

First Name *This question is required.

Last Name *This question is required.

Gender *This question is required. Cisgender: a term used to describe a person whose gender identity aligns with that typically associated with the sex assigned to them at birth.

Transgender: a term used to describe people whose gender identity does not match expectations based on the sex they were assigned at birth

Non-Binary: an adjective referring to any person whose gender identity is neither male nor female.

Date of Birth *This question is required.

Our Program is open to youth ages 7-16

This question requires a valid date format of MM/DD/YYYY.

calendar

Are you the parent/guardian of the child? *This question is required.

What is your name? *This question is required.

How are you related to the child? *This question is required.

What is your email address? This question requires a valid email address.

What is your telephone number? *This question is required. Please enter your phone number in the following format: xxx-xxx-xxxx

What is the name of your organization?

Parent/Guardian's First Name *This question is required.

Parent/Guardian's Last Name *This question is required.

Home Address

Street Address *This question is required.

Apartment Number

Borough

City *This question is required.

State *This question is required.

Residential Zip Code *This question is required.

Please enter your telephone number in the following format: XXX-XXX-XXXX

Home Telephone Number *This question is required.

Mobile Telephone Number Please enter your mobile number so you can receive text reminders for your Big Brothers Big Sisters appointments.

Work Telephone Number

Parent/Guardian's Email This question requires a valid email address.

Which of the following subway lines are close to your residence?

Preferred Language (Child)

English
Cantonese
Mandarin
Korean
Spanish
French

Preferred Language (Parent/Guardian)

English
Spanish
Korean
Mandarin
Cantonese
French

Have you ever contacted us before?

Please let us know how you heard about Big Brothers Big Sisters of New York City:

Please enter an 'other' value for this selection.

Why does this child need a mentor?