President: Lacey Neumann

President: Lacey Neumann

(469) 499-6113

Campus Advisor: Leah Kahn

Office: (936)-468-1642 and Cell: (936)-552-6101

Dear Parents/Guardian:

We would like to introduce you to an exciting SFA organization. Big Jacks is an organization that pairs children in Nacogdoches ISD (Little Jacks) ages 6 to 12 up with mature students that attend Stephen F. Austin State University (Big Jacks). Potential Big Jacks go through background check, an interview and training before they can be paired with any Little Jacks. The goal of this program is to help children by being a friend and a role model to them. Each Big Jack is dedicated to making a difference in your child’s life.

Big Jacks meet with their Little Jacks at least one hour a week. During that hour, they do lots of fun activities like bowling, skating and going to the park. They also expose the children to the importance of education through doing homework together and attending activities at SFA. There is also an opportunity for everyone in the organization to come together for an event once a month.

We would love to have your child as a part of our program. If you feel your child would benefit from this program please complete the enclosed application and permission slips and return them to the school counselor. If your child is eligible for the program, they will be paired as soon as we find a Big Jack that has completed the requirements and shares the same interests and goals as your child. Please be aware that this process of pairing takes time and you will be contacted by a Big Jack as soon as possible. If we do not have enough Big Jacks then your child may be placed on a waiting list until one becomes available.

If you have any questions please feel free to contact Leah Kahn, Campus Advisor, at work: (936)-468-1642 or by cell: (936)-552-6101.

Please keep this page and return only the application to the school counselor.

Thank you,

Big Jack Officers and Advisor

Little Jack Application and Permission Sheet

This application MUST be completed by a parent or guardian

Name: Nickname:______Age: Sex: ______

Birthday: School attending:

Address:

Phone number:Parent/Guardian name:

(Please be sure to put down current information. If we have tried and are unable to reach

You, your child may be dropped from the waiting list).

Emergency Contact name:Phone:

Does your child have any medical concerns: YES NO

If yes, please explain:

Is your child taking medication: YES NO

If yes, please explain:

Does your child have any disabilities or impairments?:

Do you have another child that is enrolled in the Big Jack program: YES NO

If yes, please give their name:

Would you prefer to have your child paired with a:

_____male _____female _____doesn’t matter

Please understand if we do not have a Big Jack that fits this preference

your child will be placed on a waiting list.

Hobbies/Interests of student:

Favorite Sport(s):

Career Goals:

Please tell us how you think your child will benefit from Big Jacks

I give permission for my son /daughter

(Parent/Guardian printed name) (please circle one)

to be a participant in the Big Jack Program through

(child’s name printed)

SFA. All of my questions have been answered to my satisfaction. I understand I will meet with the Big Jack my child is paired up with and will be provided with their name and phone number. I also understand I can call Michelle Williams, Campus Advisor, at work or home any time I have a question or concerns. I understand that this application has to be complete in order for my son/daughter to be eligible for Big Jacks.

I give my son/daughter permission to ride in the vehicle of the Big Jack once I have met them. I understand this is a volunteer program and will not hold anyone associated with Big Jacks or Stephen F. Austin State University responsible for accidents or injuries that may occur.

(Parent/Guardian)(Date)

PHOTO/VIDEO/WEB SITE PERMISSION FORM

Dear Parent/Guardian:

There may be opportunities during outings with Big Jacks that your child could be part of a story that may air on television or in one of the local newspapers. We will also have an opportunity to place pictures on our web site. Do we have your permission to have your child in any story that may arise during the time they are in Big Jacks?

Yes No

(Parent/Guardian Signature)(Date)

Please note that only completed applications will be considered for pairing. The completed application will include this form as well as the counselor application.