Enroll A Child

If you are interested in enrolling your child in one of the Big Brothers Big Sisters of North Central Indiana programs, please fill out and submit the inquiry form below. After you submit your inquiry, you can download an application packet for the program you are interested in. Once your inquiry is received, one of our case mangers or program coordinators will contact you. You can also call either the case manager or program coordinator in your county. The phone numbers are listed below and on the Staff page.

Parent/Guardian Information

First Name*    Last Name*      
Street*        Apt.         
City*          State        
Zip Code*      Telephone*   
Email Address	

Child's Information
First Name*    Last Name*    
Age*           Program*

Comments 

   

* Indicates required information.