Volunteer Prematching Checklist

Volunteer Name: Date Completed:

1.) Do you anticipate any of the following in the next 12 months? Check all that apply

Begin a new job

Travel extensively or study abroad
Start an internship/return to school
Join a new club/organization
Start a new volunteer experience (that is not Big Brothers Big Sisters)
Change living situation
Change marital status
Pregnancy/Adoption
Other

2.) On a scale of 1-5 how confident are you that you can meet consistently:
once a week (Traditional); twice per month (ACES). Circle One.

1 2 3 4 5
now confident/worried neutral extremely confident

3.) Is there anything that will be potentially challenging for you about meeting consistently
for a minimum of 12 months?

4.) Action Step—If you would prefer NOT to move forward with being matched to a little at this
time, will you contact us when you’re ready to resume the process OR would you like for us to follow-
up with you? If so, when?