Your school has partnered with Big Brothers Big Sisters of Waterloo Region (BBBSWR) to participate in our In-School Mentoring Program (ISM) for the 2024/2025 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 The child is withdrawn from class to work one-to-one with a mentor for an hour a week, in the school, during school hours.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:

  1. Complete the Teacher Referral Package
  2. Send the Child Application Package home to be completed by the child’s caregiver
  3. 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 a match is not guaranteed as we are a volunteer-based organization and programming is dependent on the number of volunteers we have and the location they can travel to.

If you have any questions, please feel free to contact a BBBSWR staff member.

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Contact Information

Student's Legal Name*
Student's Preferred Name*
Teacher's Name*
What is the reason for referral?
Match Goals: Please check three main goals that you would like to see as outcomes stemming from the student’s participation in a match relationship.*
Is the student recieving any additional support at school?*
Does the student have any attendance concerns?*
PARENT/GUARDIAN APPLICATION PACKAGE to be sent home with each student you would like to refer. The parent/guardian must sign the included consent form prior to their child taking part in the program. Here is a link to the online Parent/Guardian application package: Click Here.
If you would like a paper copy to send home, please see the attached application included in the Welcome email.
All children who participate in BBBSWR programs must have Pre-Match Training. This training has three primary purposes, to: prepare match participants for their role in a healthy, successful mentoring relationship; illuminate safety issues and strategies; and, emphasize that resources and ongoing support will be available to all match participants. A BBBSWR Program Coordinator will schedule this training as required.
Information given will be held in strict confidence and will be used to effectively assess the student's need for the In-School Mentoring program. Please feel free to contact Big Brothers Big Sisters at 519-745-0180 ext. 207 if you have any further comments or questions.
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