In-School Mentoring Student Referral Application
Your school has partnered with Big Brothers Big Sisters of Waterloo Region (BBBSWR) to participate in our In-School Mentoring Program (ISM) for the 2023/2024 school year! ISM provides elementary students who would benefit from extra social, emotional or academic support with a caring adult mentor. The child is withdrawn from class to work one-to-one with a mentor for an hour a week, in the school, during school hours. The program was developed to help children gain confidence, improve skills and assist them in reaching their potential.
All mentors for this program are thoroughly screened by BBBSWR staff. The screening process includes a police reference check, references and an in-depth assessment interview with a program coordinator. *While mentors may have previous experience with children and receive some training from the agency, they are not equipped to support students who have high needs or serious behavioural issues.
If you have a new student that you feel would benefit from extra one-to-one support, the following steps are required for student referral:
- Complete the Teacher Referral Package
- Send the Child Application Package home to be completed by the child’s caregiver
- Return the 3 completed forms to BBBSWR via your school liaison:
- STUDENT REFERRAL FORM (filled out by school staff member)
- CHILD INFORMATION FORM (filled out by caregiver)
- CONSENT FORM (filled out by caregiver)
As a reminder these forms are only needed for students who have not previously been referred to the ISM program during the last school year.
Please return these forms to your school liaison who will then forward them on to BBBSWR. Once consent and referral forms are returned to BBBSWR, students appropriate for the program will be placed on a waiting list to be matched with a mentor. Please note that while we try to get as many students as possible matched in the program, we are a volunteer-based organization and therefore cannot guarantee a match for all students referred.
If you have any questions, please feel free to contact a BBBSWR staff member.