I'd like to become a Big Brother, Big Sister
or Big Couple in Trempealeau County!
*Your first and last name:
*Email address:
*Phone number:
Alternate phone number:
*Address:
*City and state:
*Zip code:
Best way to contact me:
Best time to contact me:
Do you have a car?
Do you plan to be in the area for the
next 12-18 months?
Are you 18 or over?
*I am interested in:
What prompted you to contact
Big Brothers Big Sisters today?
(Please click on the option that
fits best.  Scroll down for more
options.)
Any additional information you'd
like to share:
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Date of Birth
Community based mentoring
  • 2-3 hours per week
  • for at least one year
  • doing things with a Little
    Brother or Little Sister in the
    community
  • at least 18 years old
  • must have access to insured,
    reliable transportation
 Site based mentoring
  • 1-2 hours per week
  • at least through the
    end of the school year
  • meet at the mentoring
    site only
  • must be at least in
    10th grade
  • do not need access to
    a car
Either
 Not sure
Please be sure to
double check your
email address and
phone number for
accuracy!