Highlights from this Manual
Inbound Program Highlights
Inbound Orientation Session
Halloween Weekend
Country Fair (no overnight)
Inbounds at Outbound Orientation
5950 District Conference
5960 District Conference
Valleyfair Weekend
September 7, 2013
October 26-27, 2013
December 7, 2013
February 22, 2014
May 2, 2014
April 24-26, 2014
June 14-15, 2014
Eastern States Bus Tour
June 15-July 1, 2014
Roseville Middle School
St. Croix Falls/Taylors Falls
Roseville Middle School
Roseville Middle School
Radisson Blu, Mall of America
National Sports Center, Blaine
Shakopee
Club budget for Inbound Student: Approximately $3,000
Inbound students cannot get a Social Security Card.
Inbound students can work for cash if money is needed by the student.
Driver’s Training class is NOT allowed for inbound students.
Rotary I.D. card and insurance card should always be in the inbound student’s wallet.
Outbound Program Highlights
$6,500 Program Fee, paid by outbound student.
$ 150 fee charged to club for each of the first two outbound students. Additional students
are free.
Mid October, 2013
November 9, 2013
December 7, 2013
Local Rotarians interview candidates.
Send completed applications to Diane Confer at YE Office.
District Interviews at Roseville Area Middle School.
Mandatory Outbound Orientations: January 25, 2014; February 22, 2014; April 12, 2014
Forms to be sent to the North Star Office
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Forms A, B, C, D (online) for all host family members age 18 and older; Rotarians
who have a specific role with the students should complete Form D, online or hard
copy, every year.
YE Officer Contact Information (yellow)
Host Family Contact Information (pink) - tell us within 10 days of changing families
Club Certification (2-ply form)
Monthly Contact Sheets for Inbound Student and Host Families (3-ply form)
Inbound Student Request form (green) to indicate preference for country of inbound
End-of-year Evaluation forms for Exchange Student, Parent, and Host Family
Icon denotes a “To-Do” task.
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TABLE OF CONTENTS
Summary of Forms to Return to the North Star Office .................................................... i
GENERAL INFORMATION and Statement of Conduct ................................................... 1
Youth Exchange Committee Directory ................................................................................. 2
Youth Exchange Regulations ............................................................................................... 3
Council on Standards for International Educational Travel (CSIET) .................................... 3
Highlights of United States Department of State Regulations .............................................. 4
Organizing Your Club’s Youth Exchange Committee........................................................... 5
Club Youth Exchange Officer Overview .................................................................... 5
Outbound Student Committee Overview................................................................... 5
Inbound Student Committee Overview...................................................................... 5
Inbound Student Counselor Overview....................................................................... 5
Host Family Support Committee Overview ............................................................... 5
Club Youth Exchange Officer Overview ............................................................................... 6
Annual Training Requirements ............................................................................................. 7
Government Regulations.................................................................................................8-12
Clarification of Rules for Inbound Students ........................................................................ 13
Program Rules and Conditions of Exchange ................................................................14-17
Instructions on Using Forms A, Addendum A, B, C, D ....................................................... 18
Using the Forms ................................................................................................................. 19
Instructions for Form A and Addendum Form A ................................................................. 20
Instructions for Form B ....................................................................................................... 21
Instructions for Form C ....................................................................................................... 22
Instructions for Form D - Online Background Check Process ............................................ 23
Youth Exchange Supplies Order Form............................................................................... 24
OUTBOUND PROGRAM and Statement of Conduct.................................................... 25
Calendar for Outbound Program ........................................................................................ 26
Outbound Youth Exchange Program Costs ....................................................................... 27
Financial Assistance ........................................................................................................... 27
Memo: Student’s Cost of Participation in Rotary Youth Exchange Program...................... 28
Refund Schedule ................................................................................................................ 28
Outbound Student Committee Responsibilities .................................................................. 29
Tips for the Club Exchange Officer (Outbound) ................................................................. 30
Sample News Releases .................................................................................................... 31
Club Interview Rating Sheet ............................................................................................... 32
Sample Questions for Outbound Candidate at the Club Interview ..................................... 33
Sample Questions for Parents at the Club Interview .......................................................... 34
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TABLE OF CONTENTS (Continued)
INBOUND PROGRAM and Statement of Conduct......................................................... 35
Calendar for Inbound Program Events ............................................................................... 36
Inbound Student Committee Responsibilities ..................................................................... 37
High School Registration of Inbound Exchange Students.................................................. 38
Inbound Student Counselor Responsibilities .................................................................39-40
Host Family Traveling Binder ............................................................................................. 41
Assignments of Inbound Exchange Students to Host Clubs .............................................. 42
Inbound Orientation ............................................................................................................ 42
Address Changes ............................................................................................................... 42
Driver Training .................................................................................................................... 42
Employment........................................................................................................................ 42
Tax Information for Host Families....................................................................................... 42
Rotary Sponsored Summer Eastern States Trip ................................................................ 43
Travel with Host Families and Rotary Families .................................................................. 43
Travel to Another Country .................................................................................................. 43
Rules for Unaccompanied Travel ....................................................................................... 44
Unaccompanied Travel Permission Form .......................................................................... 45
Inbound Student Costs to Host Club .................................................................................. 46
Monthly Financial Support .................................................................................................. 46
HOST FAMILY SECTION and Statement of Conduct .................................................... 47
Host Family Committee Responsibilities .......................................................................48-49
Tips on Finding Host Families .......................................................................................50-51
Post-Exchange Evaluation Forms for Students, Parents, and Host Families ................ …51
Host Family Checklist ......................................................................................................... 52
APPENDIX and Statement of Conduct ........................................................................... 53
Eden Prairie AM Rotary Youth Exchange Calendar Sample 2009-10 ..........................55-56
Sample ID Card .............................................................................................................57-58
Host Family Traveling Binder ............................................................................................. 59
Sample Email Communication to Incoming Inbound Student ............................................ 60
Myth-Busting....................................................................................................................... 61
Why Do Youth Exchange - - - An Inbound Student’s Message ......................................... 62
Sample Certificate of Eligibility for Exchange Visitors (DS-2019)....................................... 63
YEO’s Guide to the Database .......................................................................................64-66
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GENERAL
INFORMATION
STATEMENT OF CONDUCT FOR WORKING WITH YOUTH
Rotary International is committed to creating and maintaining the safest possible environment
for all participants in Rotary activities. It is the duty of all Rotarians, Rotarians’ spouses,
partners, and other volunteers to safeguard to the best of their ability the welfare of and to
prevent the physical, sexual, or emotional abuse of children and young people with whom they
come into contact.
Adopted by the RI Board of Directors, November 2002
Adopted by Multi-District 5950-5960 Rotary Youth Foundation, January 2006
Adopted by District 5950 District Assembly, April 2006
Adopted by District 5960 Assembly, April 2006
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Back of letterhead -2COLLEEN PLEASE PROVIDE
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Youth Exchange Regulations
North Star Rotary Youth Exchange is regulated by Rotary International, United States
Department of State, and Council on Standards for International Educational Travel
(CSIET)
Rotary International has established regulations that all Rotary districts must follow. We are
not allowed to exchange with districts not adhering to these policies.
The US Department of State has the power of control in the number of students we can
host each year. Therefore, through an annual audit by the DOS we are obligated to closely
follow all of their regulations.
CSIET is an organization consisting of approximately 70 International Educational Travel
and Exchange Programs and High Schools in the United States.
Council on Standards for International Educational Travel (CSIET)
The Council on Standards for International Educational Travel (CSIET) is a governing
organization that has established various standards that all youth exchange programs must
meet to rate a listing in a publication supplied to all secondary schools. School officials can
then determine the legitimacy of youth exchange programs attempting to place exchange
students in their schools.
It is important that exchange programs such as Rotary have a good rating at all times with
CSIET. It is imperative that our district Rotary clubs closely follow these regulations by
attending annual trainings.
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Highlights of the United States Department of State Regulations
A comprehensive list of Department of State regulations is in the appendix of this manual.
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Club exchange officers must participate in annual training sessions.
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Club exchange officers must submit to a background check each year.
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Club exchange officers must take Department of State test each year.
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Club exchange officers must complete the above three regulations prior to placing
or interacting with the student.
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The first host family must be designated prior to arrival of student.
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Criminal and sexual background checks for all host family members living at home
who are 18 years of age or more each year they host.
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In-home interviews of all host family members in their home (each time they host)
and at least two reference checks for each host family member 18 years of age and
older.
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A second in-home visit to the home within two months of the student’s placement
by a different member of the Club.
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Maintain and record on the contact schedule form, at a minimum, a monthly contact
with the host family and inbound student.
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Make no monetary payments or other incentives to host families.
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Photos of the home and rooms the student will use in the house (student’s
bedroom, bathroom, kitchen, family/living room and exterior and grounds).
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Inbound students must be provided with a profile of host family, school and
community prior to arrival. (Copies of all correspondence with the student must be
forwarded to the District YE Office).
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Do not take the student’s passport or other government documents from the student
unless the student requests your assistance for safe storage of these
documents. These documents must be in their possession or accessible to the
student at all times.
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Provide the school with the student’s translated grade transcript in English.
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Prior to departure from his/her home country, provide the student an ID card with
phone number, address etc. of host family, Rotary Club president and Youth
Exchange Officer contact information, school, and other pertinent information. (See
sample ID card in the appendix.)
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Organizing Your Club's Youth Exchange Committee
The following suggested committee structure may be helpful as you implement the exchange
program in your club. We suggest a minimum of 3 people on your committee.
A. Club Youth Exchange
Officer
B. Outbound Student
Committee
C. Inbound Student
Committee
D. Inbound Student
Counselor
E. Host Family
Support Committee
A. Club Youth Exchange Officer (YEO) Overview
The club YEO is responsible for the overall smooth operation of the club’s youth exchange
program. For full description, see following page.
B. Outbound Student Committee Overview
The Outbound committee leader is responsible for recruiting and screening potential North
Star Rotary Youth Exchange Students. For more details on this role, see Outbound section.
C. Inbound Student Committee Overview
The inbound student committee is responsible for the overall communications with the club’s
inbound student and the host school. For more details on this role, see Inbound section..
D. Inbound Student Counselor Overview
The counselor is responsible for the general well-being of the exchange student and is to
serve as a guide and mentor for the student. For more details on this role, see Inbound
section.
E. Host Family Support Committee Overview
The host family support committee is responsible for the selection, vetting and support of host
families throughout the exchange year. For more details on this role, see Host Family section.
Online training for each of these roles is available on the Youth Exchange Website:
www.northstaryouthexchange.com. Click on News, then Online Training is Here! There are
four modules; take the training annually, as forms and information are updated each Rotary
year.
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Club Youth Exchange Officer Overview
1.
Coordinate the Youth Exchange Program at the club level.
2.
Copy the North Star Office on all communications with your inbound student,
prior to arrival. (diane.confer@comcast.net or mail, or fax: 763-550-0619)
3.
Keep informed of inbound exchange student’s progress and adjustment.
4.
Inform the North Star Office of the current host family name, address, phone
number and email. Within 10 days of moving to the new host family, provide the new
family’s name, address, phone number and email. (diane.confer@comcast.net; fax:
763-550-0619).
5.
Maintain file of Youth Exchange procedures and correspondence for a minimum of
three years.
6.
Complete online Club Youth Exchange Officer Training annually; available at
www.northstaryouthexchange.com.
7.
Complete online Department of State Training (Traincaster) annually.
8.
Suggested: Recommend someone from your club’s Youth Exchange Committee
attend the Inbound Orientation Session with your inbound student.
9.
Submit the Inbound Student Request Form by November 9, indicating from which
country your club would like to host a student, and the number of students your club is
willing to host and send (if known). Also submit the Club Certificate of Intent for
Hosting an Inbound Student Form by August 15.
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Annual Training Requirements
For Club Exchange Officer and all Committee Members
Our mandatory trainings are online. Complete them all in the month
of July so you are prepared for the August inbound arrivals.
1. Department of State online training
This will be sent to the Youth Exchange Officer via email once a year. At least one
person per Rotary club needs to complete this. (See additional information on
following page.)
2. The North Star Rotary Youth Exchange Program Training
Four short modules describing North Star procedures are available online:
http://tom.intratrain.com/rotaryexchange/.
Go to Youth Exchange Officer tab on the website:
www.NorthStarYouthExchange.com
3. Youth Protection Training
Contact Rhianna Gawrys for your sign-in: rhianna.gawrys@gmail.com;
651-500-2297
4. Periodically, we will offer face-to-face trainings that focus on particular topics. You
are encouraged to attend these.
For Host Parents
1. Attend one of the Host Family Trainings. They will be offered at the Inbound
Orientation (first Saturday after Labor Day), and January Outbound Orientation.
2. Read the Host Parent Handbook.
For Rotex Officers
1. Youth Protection Training
Contact Rhianna Gawrys for your sign-in: rhianna.gawrys@gmail.com;
651-500-2297
US Department of State Annual Training
The US Department of State provides an online training program. We require that at least
one member of the local Rotary club Youth Exchange committee completes this training
annually. Also, one of the committee members who will conduct the in-home interview
must complete this training.
Review the material in “Government Regulations” found on the next four pages before you
begin this training.
Committee members who have taken this training previously need only to login at the link
listed below. A new committee member or first-time user must first contact Allen Gerdin
(algerdin@att.net) to receive a login name and password.
The link for returning Rotarians is: https://doslocalcoordinatortraining.traincaster.com
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Government Regulations
(HINT: Review this before taking the annual DOS Online, open-book test)
§ 62.25 Secondary school students. - As of January 29, 2011
(a) Purpose. This section governs Department of State designated exchange visitor programs under which foreign secondary school
students are afforded the opportunity to study in the United States at accredited public or private secondary schools for an academic
semester or an academic year, while living with American host families or residing at accredited U.S. boarding schools.
(b) Program sponsor eligibility. Eligibility for designation as a secondary school student exchange visitor program sponsor is limited to
organizations:
(1) With tax-exempt status as conferred by the Internal Revenue Service pursuant to section 501(c)(3) of the Internal Revenue Code; and
(2) Which are United States citizens as such term is defined in §62.2.
(c) Program eligibility. Secondary school student exchange visitor programs designated by the Department of State must:
(1) Require all exchange students to be enrolled and participating in a full course of study at an accredited academic institution;
(2) Allow entry of exchange students for not less than one academic semester (or quarter equivalency) and not more than two academic
semesters (or quarter equivalency) duration; and
(3) Ensure that the program is conducted on a U.S. academic calendar year basis, except for students from countries whose academic
year is opposite that of the United States. Exchange students may begin an exchange program in the second semester of a U.S.
academic year only if specifically permitted to do so, in writing, by the school in which the exchange student is enrolled. In all cases,
sponsors must notify both the host family and school prior to the exchange student's arrival in the United States whether the placement is
for an academic semester, an academic year, or a calendar year.
(d) Program administration. Sponsors must ensure that all organizational officers, employees, representatives, agents, and
acting on their behalf:
volunteers
(1) Are adequately trained. Sponsors must administer training for local coordinators that specifically includes, at a minimum, instruction
in: Conflict resolution; procedures for handling and reporting emergency situations; awareness or knowledge of child safety standards;
information on sexual conduct codes; procedures for handling and reporting allegations of sexual misconduct or any other allegations of
abuse or neglect; and the criteria to be used to screen potential host families and exercise good judgment when identifying what
constitutes suitable host family placements. In addition to their own training, sponsors must ensure that all local coordinators complete
the Department of State mandated training module prior to their appointment as a local coordinator or assumption of duties. The
Department of State training module will include instruction designed to provide a comprehensive understanding of the Exchange Visitor
Program; its public diplomacy objectives; and the Secondary School Student category rules and regulations. Sponsors must
demonstrate the individual's successful completion of all initial training requirements and that annual refresher training is also
successfully completed.
(2) Are adequately supervised. Sponsors must create and implement organization-specific standard operating procedures for the
supervision of local coordinators designed to prevent or deter fraud, abuse, or misconduct in the performance of the duties of these
employees/agents/volunteers. They must also have sufficient internal controls to ensure that such employees/agents/volunteers comply
with such standard operating procedures.
(3) Have been vetted annually through a criminal background check (which must include a search of the Department of Justice's National
Sex Offender Public Registry);
(4) Place no exchange student with his or her relatives;
(5) Make no exchange student placement beyond 120 miles of the home of the local coordinator authorized to act on the sponsor's behalf
in both routine and emergency matters arising from that exchange student's participation in the Exchange Visitor Program;
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(6) Make no monetary payments or other incentives to host families;
(7) Provide exchange students with reasonable access to their natural parents and family by telephone and e-mail;
(8) Make certain that the exchange student's government issued documents ( i.e. , passports, Forms DS–2019) are not removed from
his/her possession;
(9) Conduct the host family orientation after the host family has been fully vetted and accepted;
(10) Refrain, without exception, from acting as:
(i) Both a host family and a local coordinator or area supervisor for an exchange student;
(ii) A host family for one sponsor and a local coordinator for another sponsor; or
(iii) A local coordinator for any exchange student over whom he/she has a position of trust or authority such as the student's teacher or
principal. This requirement is not applicable to a boarding school placement.
(11) Maintain, at minimum, a monthly schedule of personal contact with the exchange student. The first monthly contact between the
local coordinator and the exchange student must be in person. All other contacts may take place in-person, on the phone, or via
electronic mail and must be properly documented. The sponsor is responsible for ensuring that issues raised through such contacts are
promptly and appropriately addressed.
(12) That a sponsor representative other than the local coordinator who recruited, screened and selected the host family visit the
exchange student/host family home within the first or second month following the student's placement in the home.
(13) Maintain, at a minimum, a monthly schedule of personal contact with the host family. At least once during the fall semester and at
least once during the spring semester, ( i.e. , twice during the academic year) the contact by the local coordinator with the host family
must be in person. All other contacts may take place in person, on the phone, or via electronic mail and must be properly documented.
The sponsor is responsible for ensuring the issues raised through such contacts are promptly and appropriately addressed.
(14) That host schools are provided contact information for the local organizational representative (including name, direct phone number,
and e-mail address), the program sponsor, and the Department's Office of Designation; and
(15) Adhere to all regulatory provisions set forth in this Part and all additional terms and conditions governing program administration that
the Department may impose.
(e) Student selection. In addition to satisfying the requirements of §62.10(a), sponsors must ensure that all participants in a designated
secondary school student exchange visitor program:
(1) Are secondary school students in their home countries who have not completed more than 11 years of primary and secondary study,
exclusive of kindergarten; or are at least 15 years of age, but not more than 18 years and six months of age as of the program start date;
(2) Demonstrate maturity, good character, and scholastic aptitude; and
(3) Have not previously participated in an academic year or semester secondary school student exchange program in the United States
or attended school in the United States in either F–1 or J–1 visa status.
(f) Student enrollment. (1) Sponsors must secure prior written acceptance for the enrollment of any exchange student in a United States
public or private secondary school. Such prior acceptance must:
(i) Be secured from the school principal or other authorized school administrator of the school or school system that the exchange student
will attend; and
(ii) Include written arrangements concerning the payment of tuition or waiver thereof if applicable.
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(2) Under no circumstance may a sponsor facilitate the entry into the United States of an exchange student for whom a written school
placement has not been secured.
(3) Under no circumstance may a sponsor charge a student private school tuition if such arrangements are not finalized in writing prior to
the issuance of Form DS–2019.
(4) Sponsors must maintain copies of all written acceptances for a minimum of three years and make such documents available for
Department of State inspection upon request.
(5) Sponsors must provide the school with a translated “written English language summary” of the exchange student's complete
academic course work prior to commencement of school, in addition to any additional documents the school may require. Sponsors must
inform the prospective host school of any student who has completed secondary school in his/her home country.
(6) Sponsors may not facilitate the enrollment of more than five exchange students in one school unless the school itself has requested,
in writing, the placement of more than five students from the sponsor.
(7) Upon issuance of a Form DS–2019 to a prospective participant, the sponsor accepts full responsibility for securing a school and host
family placement for the student, except in cases of voluntary student withdrawal or visa denial.
(g) Student orientation. In addition to the orientation requirements set forth at §62.10, all sponsors must provide exchange students, prior
to their departure from their home countries, with the following information:
(1) A summary of all operating procedures, rules, and regulations governing student participation in the exchange visitor program along
with a detailed summary of travel arrangements;
(2) A copy of the Department's welcome letter to exchange students;
(3) Age and language appropriate information on how to identify and report sexual abuse or exploitation;
(4) A detailed profile of the host family with whom the exchange student will be placed. The profile must state whether the host family is
either a permanent placement or a temporary-arrival family;
(5) A detailed profile of the school and community in which the exchange student will be placed. The profile must state whether the
student will pay tuition; and
(6) An identification card, that lists the exchange student's name, United States host family placement address and telephone numbers
(landline and cellular), sponsor name and main office and emergency telephone numbers, name and telephone numbers (landline and
cellular) of the local coordinator and area representative, the telephone number of Department's Office of Designation, and the Secondary
School Student program toll free emergency telephone number. The identification card must also contain the name of the health
insurance provider and policy number. Such cards must be corrected, reprinted, and reissued to the student if changes in contact
information occur due to a change in the student's placement.
(h) Student extra-curricular activities. Exchange students may participate in school sanctioned and sponsored extra-curricular activities,
including athletics, if such participation is:
(1) Authorized by the local school district in which the student is enrolled; and
(2) Authorized by the state authority responsible for determination of athletic eligibility, if applicable. Sponsors shall not knowingly be party
to a placement (inclusive of direct placements) based on athletic abilities, whether initiated by a student, a natural or host family, a school,
or any other interested party.
(3) Any placement in which either the student or the sending organization in the foreign country is party to an arrangement with any other
party, including receiving school personnel, whereby the student will attend a particular school or live with a particular host family must be
reported to the particular school and the National Federation of State High School Associations prior to the first day of classes.
(i) Student employment. Exchange students may not be employed on either a full or part-time basis but may accept sporadic or
intermittent employment such as babysitting or yard work.
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(j) Host family application and selection. Sponsors must adequately screen and select all potential host families and at a minimum must:
(1) Provide potential host families with a detailed summary of the Exchange Visitor Program and of their requirements, obligations and
commitment to host;
(2) Utilize a standard application form developed by the sponsor that includes, at a minimum, all data fields provided in Appendix F,
“Information to be Collected on Secondary School Student Host Family Applications”. The form must include a statement stating that:
“The income data collected will be used solely for the purposes of determining that the basic needs of the exchange student can be met,
including three quality meals and transportation to and from school activities.” Such application form must be signed and dated at the time
of application by all potential host family applicants. The host family application must be designed to provide a detailed summary and
profile of the host family, the physical home environment (to include photographs of the host family home's exterior and grounds, kitchen,
student's bedroom, bathroom, and family or living room), family composition, and community environment. Exchange students are not
permitted to reside with their relatives.
(3) Conduct an in-person interview with all family members residing in the home where the student will be living;
(4) Ensure that the host family is capable of providing a comfortable and nurturing home environment and that the home is clean and
sanitary; that the exchange student's bedroom contains a separate bed for the student that is neither convertible nor inflatable in nature;
and that the student has adequate storage space for clothes and personal belongings, reasonable access to bathroom facilities, study
space if not otherwise available in the house and reasonable, unimpeded access to the outside of the house in the event of a fire or
similar emergency. An exchange student may share a bedroom, but with no more than one other individual of the same sex.
(5) Ensure that the host family has a good reputation and character by securing two personal references from within the community from
individuals who are not relatives of the potential host family or representatives of the sponsor ( i.e. , field staff or volunteers), attesting to
the host family's good reputation and character;
(6) Ensure that the host family has adequate financial resources to undertake hosting obligations and is not receiving needs-based
government subsidies for food or housing;
(7) Verify that each member of the host family household 18 years of age and older, as well as any new adult member added to the
household, or any member of the host family household who will turn eighteen years of age during the exchange student's stay in that
household, has undergone a criminal background check (which must include a search of the Department of Justice's National Sex
Offender Public Registry);
(8) Maintain a record of all documentation on a student's exchange program, including but not limited to application forms, background
checks, evaluations, and interviews, for all selected host families for a period of three years following program completion; and
(9) Ensure that a potential single adult host parent without a child in the home undergoes a secondary level review by an organizational
representative other than the individual who recruited and selected the applicant. Such secondary review should include demonstrated
evidence of the individual's friends or family who can provide an additional support network for the exchange student and evidence of the
individual's ties to his/her community. Both the exchange student and his or her natural parents must agree in writing in advance of the
student's placement with a single adult host parent without a child in the home.
(k) Host family orientation. In addition to the orientation requirements set forth in §62.10, sponsors must:
(1) Inform all host families of the philosophy, rules, and regulations governing the sponsor's exchange visitor program, including examples
of “best practices” developed by the exchange community;
(2) Provide all selected host families with a copy of the Department's letter of appreciation to host families;
(3) Provide all selected host families with a copy of Department of State-promulgated Exchange Visitor Program regulations;
(4) Advise all selected host families of strategies for cross-cultural interaction and conduct workshops to familiarize host families with
cultural differences and practices; and
(5) Advise host families of their responsibility to inform the sponsor of any and all material changes in the status of the host family or
student, including, but not limited to, changes in address, finances, employment and criminal arrests.
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(l) Host family placement. (1) Sponsors must secure, prior to the student's departure from his or her home country, a permanent or arrival
host family placement for each exchange student participant. Sponsors may not:
(i) Facilitate the entry into the United States of an exchange student for whom a host family placement has not been secured;
(ii) Place more than one exchange student with a host family without the express prior written consent of the host family, the natural
parents, and the students being placed. Under no circumstance may more than two exchange students be placed with a host family, or in
the home of a local coordinator, regional coordinator, or volunteer. Sponsors may not place students from the same countries or with the
same native languages in a single home.
(2) Prior to the student's departure from his or her home country, sponsors must advise both the exchange student and host family, in
writing, of the respective family compositions and backgrounds of each, whether the host family placement is a permanent or arrival
placement, and facilitate and encourage the exchange of correspondence between the two.
(3) In the event of unforeseen circumstances that necessitate a change of host family placement, the sponsor must document the
reason(s) necessitating such change and provide the Department of State with an annual statistical summary reflecting the number and
reason(s) for such change in host family placement in the program's annual report.
(m) Advertising and marketing for the recruitment of host families. In addition to the requirements set forth in §62.9 in advertising and
promoting for host family recruiting, sponsors must:
(1) Utilize only promotional materials that professionally, ethically, and accurately reflect the sponsor's purposes, activities, and
sponsorship;
(2) Not publicize the need for host families via any public media with announcements, notices, advertisements, etc. that are not
sufficiently in advance of the exchange student's arrival, appeal to public pity or guilt, imply in any way that an exchange student will be
denied participation if a host family is not found immediately, or identify photos of individual exchange students and include an appeal for
an immediate family;
(3) Not promote or recruit for their programs in any way that compromises the privacy, safety or security of participants, families, or
schools. Specifically, sponsors shall not include personal student data or contact information (including addresses, phone numbers or
email addresses) or photographs of the student on Web sites or in other promotional materials; and
(4) Ensure that access to exchange student photographs and personally identifying information, either online or in print form, is only made
available to potential host families who have been fully vetted and selected for program participation. Such information, if available online,
must also be password protected.
(n) Reporting requirements. Along with the annual report required by regulations set forth at §62.15, sponsors must file with the
Department of State the following information:
(1) Sponsors must immediately report to the Department any incident or allegation involving the actual or alleged sexual exploitation or
any other allegations of abuse or neglect of an exchange student. Sponsors must also report such allegations as required by local or
state statute or regulation. Failure to report such incidents to the Department and, as required by state law or regulation, to local law
enforcement authorities shall be grounds for the suspension and revocation of the sponsor's Exchange Visitor Program designation;
(2) A report of all final academic year and semester program participant placements by August 31 for the upcoming academic year or
January 15 for the Spring semester and calendar year. The report must be in the format directed by the Department and must include at
a minimum, the exchange student's full name, Form DS–2019 number (SEVIS ID #), host family placement (current U.S. address), school
(site of activity) address, the local coordinator's name and zip code, and other information the Department may request; and
(3) A report of all situations which resulted in the placement of an exchange student with more than one host family or in more than one
school. The report must be in a format directed by the Department and include, at a minimum, the exchange student's full name, Form
DS–019 number (SEVIS ID #), host family placements (current U.S. address), schools (site of activity address), the reason for the change
in placement, and the date of the move. This report is due by July 31 for the previous academic school year.
[75 FR 65981, Oct. 27, 2010]
-12-
Clarification of Rules for Inbound Students
hosted in Districts 5950 and 5960
I, _____________________________________________, understand and agree that:
(Print your name here)
1. It is illegal in Minnesota and Wisconsin to drink alcohol of any sort (beer, wine,
vodka, etc.) if you are under the age of 21.
2. It is illegal in Minnesota and Wisconsin to use street drugs such as marijuana,
cocaine, LSD, etc.
3. It is illegal in Minnesota and Wisconsin to take prescription drugs (hydrocodone,
tramadol, Percocet, Methadone, etc.) without a prescription.
4. It is against Rotary rules to have any sort of sexual contact during a Rotary event and
during your exchange year (including exchange students, Rotary members, Rotex
members, or anyone else).
IMPORTANT: We realize that these rules may be very different from your home country. But
these are the rules in Minnesota and Wisconsin.
IMPORTANT: If you are an exchange student and violate one of these rules, you will be sent
home at your own expense.
IMPORTANT: If you are a member of Rotex and violate one of these rules, you will be
banned from all future Rotex events.
IMPORTANT: Almost every year, students get sent home for drinking, drug use, or sexual
contact. If you see or hear about someone drinking alcohol, using drugs, or having sexual
contact and tell someone from Rotary, you will not get in trouble, be punished, or be sent
home.
No Drinking! No Drugs! No Sexual Contact!
Our goal is to keep you safe!
_________________________________________
(Print your name here)
______________________________
(Your home country)
_________________________________________
(Signature)
-13-
______________________________
(Date)
Insert rules from RI Application (pages 14 and 15)
Please change #3 under Rules and Conditions of Exchange to:
3) Drinking of alcoholic beverages is expressly forbidden.
(-14- and -15-)
Rules and Conditions of Exchange for Long-Term Exchange Program
Who makes the final decision if a rule has been broken? A brief description of who
should make the final decision is explained below. All reasonable steps should be
taken to protect the privacy of those involved. All incidents should be documented
at the club level and by the Chair.
1. You must obey the laws of the host country. If found guilty of violating any law, you can
expect no assistance from your sponsors or native country. You must return home at your
own expense as soon as released by authorities. (If any alleged violation of local law
occurs, the Youth Exchange Officer immediately calls the Country officer who immediately
calls the Chair. Chair confers with the respective District Governor to make a plan.)
2. You are not allowed to possess or use illegal drugs. Medicine prescribed to you by a
physician is allowed. (If student is found with illegal drugs, follow procedure in rule #1.)
3. Drinking of alcoholic beverages is expressly forbidden. (Youth Exchange Officer
immediately calls Country officer who calls the Chair for the final decision.)
4. You may not operate a motorized vehicle or participate in driver education programs. (The
CISI-Bolduc insurance will not cover any medical expenses due to injury if an exchange
student is hurt while driving a motorized vehicle of any kind, including all two, three and four
wheeled means of transportation. This includes, but is not limited to, automobiles, motor
cycles, motorized dirt bikes of any kind, all-terrain vehicles, snowmobiles and watercraft.
This exclusion shall be waived in relation to amusement park rides, lawn mowers or
operating a golf cart, while on a golf course. Host family should be warned that if a student is
injured while driving a motorized vehicle, the person who allowed an exchange student to
drive the motorized vehicle will be personally financially responsible for any damage or injury
resulting from this action. Also, if a student is caught driving a car or truck, they must be
sent home immediately. This is one area where RI is very strict. If a student is found to be
driving a car or truck, the Youth Exchange Officer calls Country officer who calls the Chair
for the final decision.)
5. You will be under the host district’s authority while you are an exchange student and must
abide by the rules and conditions of exchange provided by the host district. Parents or legal
guardians must not authorize any extra activities directly to you. Any relatives you may have
in the host country will have no authority over you while you are in the program. (Youth
Exchange Officer calls Country officer who makes the final decision.)
6. You must attend school regularly and make an honest attempt to succeed. (Club counselor
can talk candidly with the student and the student’s school counselor to make a plan for
improvement. If attendance and grade issues continue, Club counselor contacts the
Country officer who the contacts the Chair for a decision about probation or sending home.)
-16-
7. You must have travel insurance that provides medical and dental coverage for accidental
injury and illness, death benefits (including repatriation of remains),
disability/dismemberment benefits, emergency medical evacuation, emergency visitation
expenses, 24-hour emergency assistance services, and legal services, in amounts
satisfactory to the host Rotary club or district in consultation with the sponsor Rotary club or
district, with coverage from the time of your departure from your home country until your
return. (Country officer makes sure this is purchased before a DS-2019 is issued.)
8. You should have sufficient financial support to assure your well-being during your exchange.
Your host district may require a contingency fund for emergency situations. Unused funds
will be returned to your parents or legal guardians at the end of your exchange. (Country
officer reminds student of this procedure at the Inbound Orientation. The fund’s balance
should always be $400. Youth Exchange Officer ensures the money is collected and kept in
a safe place during the exchange year. Youth Exchange Officer returns the extra funds to
the parents/legal guardians after all bills have been paid and student has returned home.)
9. You must follow the travel rules of your host district. Travel is permitted with host parents or
for Rotary club or district functions authorized by the host Rotary club or district with proper
adult chaperones. The host district and club, host family, and your parents or legal
guardians must approve any other travel in writing, thus exempting Rotary of responsibility
and liability. (In cases of obtaining permission to travel alone, the student contacts his/her
parents or legal guardian for written authorization. The Youth Exchange Officer contacts the
Country officer and the Chair for their written authorization. Authorization must be in writing
from all parties. An emailed letter of authorization is acceptable. Please use the
Unaccompanied Travel Permission Form found in the Youth Exchange Manual.)
10. You must return home directly by a route mutually agreeable to your host district and your
parents or legal guardians. (Country officer can resolve any issues.)
11. Any costs related to an early return home or any other unusual costs (language tutoring,
tours, etc.) are the responsibility of you and your parents or legal guardians. (Country officer
can resolve this.)
12. You should communicate with your first host family prior to leaving your home country. The
family’s information must be provided to you by your host club or district prior to your
departure. (Youth Exchange Officer must provide details of the host family and community
before the student departs from home country.)
13. Visits by your parents or legal guardians, siblings, or friends while you are on exchange are
strongly discouraged. Such visits may only take place with the host club’s and district’s
consent and within their guidelines. Typically, visits may be arranged only in the last quarter
of the exchange or during school breaks and are not allowed during major holidays. (Youth
Exchange Officer can handle this.)
14. Talk with your host club counselor, host parents, or other trusted adult if you encounter any
form of abuse or harassment. (The first person to know about an alleged incident of abuse
or harassment immediately contacts the Youth Exchange Officer who contacts the Country
officer who contacts the Chair. The Chair confers with the Youth Protection Officer and
respective District Governor to make a plan. Youth Exchange Officer calls the local police if
sexual abuse or harassment is alleged. Chair calls RI within 72 hours to report any alleged
sexual abuse or harassment.)
-17-
IMPORTANT INFORMATION:
Instructions on Completing Forms - A, Addendum A, B, C and D
Rotary International has established regulations for the Youth Exchange Program that have
necessitated a set of 5 forms for gathering information on all persons involved in the Youth
Exchange Program.
These forms are:
• Form A - Youth Volunteer Affidavit (green)
• Addendum Form A – (white) Volunteer Personal Reference Check
• Form B – Host Family Application 2 Pages (blue)
• Form C – Host Family In-Home Interview Form (yellow)
• Form D – Waiver/Consent Release – Complete online
Forms A and D must be completed by all who will be directly involved with Youth Exchange
students, including Host Families. Forms B and C relate only to Host Families.
Host Families must complete all forms once per year. Other volunteers must complete Form
D once every year.
When the forms have been completed and signed in all appropriate places, send all original
documents to the North Star Office (as indicated on the forms).
A detailed summary of these forms follows.
Statement of Conduct for Working with Youth
Rotary International is committed to creating and maintaining the safest possible environment for all
participants in Rotary activities. It is the duty of all Rotarians, Rotarians’ spouses, partners and
other volunteers to safeguard to the best of their ability the welfare of and to prevent the physical,
sexual, or emotional abuse of children and young people with whom they come into contact.
-18-
IMPORTANT
-12-Who Is INFORMATION:
a Volunteer?
Using the Forms
1. Club Youth Exchange Committee members.
Who Needs a Background Check?
1. Club Youth Exchange Committee members.
2. Club and non-club members who have one-on-one contact with students in the Youth
Exchange Program.
3. All adult members (18 and older) of a host family, any adult members of the family who
are living away from home and come home on a temporary basis (e.g. college students),
any other adults living in the home (e.g. grandparent, etc.).
4. All adult members of an Emergency or Temporary Host Family. These are families that
can host a student on short notice and for a short time. For example, if the normal host
family is away on vacation, the exchange student may need to stay with another host
family for a week or two. Clubs are encouraged to have at least two of these families
arranged before the exchange student arrives.
5. It is also encouraged to include other members of the club who may have a specific role
with the student, such as regularly transporting the student for club meetings, etc.
6. In general, background checks need not be conducted for adults who will have only
casual or occasional group interactions with Youth Exchange students.
Who Completes Which Forms?
The Club Youth Exchange Officer completes the shaded areas on the top of all forms
before giving to a volunteer to complete.
Form A – Youth Volunteer Affidavit – is to be completed by ALL volunteers, as defined
above.
Addendum Form A – References are to be contacted by the Club Youth Exchange Officer
for each volunteer.
Form B – Host Family Application – is to be completed by one parent in the potential host
family.
Form C – Host Family In-Home Interview Form – is to be conducted by two Rotary Club
representatives with all members of the potential host family living at home present, in the
potential host home. Required photos must be taken.
Form D – Waiver/Consent Release – to be completed by ALL volunteers online.
-19-
Form A – Youth Volunteer Affidavit (Green) and
Addendum Form A – (White)
To be completed by ALL volunteers
Three Steps to Take
1. Rotarian:
 Complete the shaded area prior to giving the form to the volunteer for completion.
 After receiving completed form from applicant, continue with Rotarian instructions
below.
2. Applicant:
 Complete and sign the form.
 Retain the third copy.
 Give the remainder of the form (attached) to the Rotary Club Contact.
3. Rotarian:
 Complete Volunteer Personal Reference Check – Addendum Form A (white), using
information provided by the applicant in the Personal References section of the Youth
Volunteer Affidavit.
 Indicate on the Personal References section of the Youth Volunteer Affidavit, whether
or not the reference check result was ‘satisfactory.’
 Submit the original copy of the Youth Volunteer Affidavit to the North Star Office.
 Retain the second copy for the club records.
-20-
Form B – Host Family Application (Blue)
To be completed by adult potential host family members
1. Rotarian:
 Complete the shaded area prior to giving the Host Family Application (blue) to the
volunteer for completion.
 After receiving completed form from applicant, continue with Rotarian instructions
below.
2. Applicant:
 Complete the Host Family Application (blue).
 Retain the third copy.
 Give all other copies (still attached) to the Rotarian.
3. Rotarian:
 Review the application.
 Schedule an in-home interview with all family members present, to be conducted by
two Rotarians. At least one of the Rotarians conducting the interview must have
completed the Department of State Training (see page 8).
 Submit the original copy of the application to the North Star Office.
 Retain the second copy for the club records.
-21-
Form C – Host Family In-Home Interview Form (Yellow)
To be conducted by two Rotarians with the potential host family
Rotarian:
 Conduct the in-home interview for a time when all host family members will be present.
 Two Rotarians from the host club must conduct the interview.
 The host parent(s) and Rotarian interviewers jointly fill out the interview form.
 Host parent(s) sign and date the form.
 The third copy is given to the potential host family at the conclusion of the interview.
 Retain the second copy for club files.
 If the family is a suitable host, send the original copy to the North Star Office.
If the family had an acceptable interview and background checks are satisfactory, the family
may be used as a host family.
If the family had an unacceptable interview, and/or their background check(s) resulted in an
unsatisfactory report, the family is not suitable to host. The District Youth Exchange Chair or
Office may be contacted for guidance at this point.
-22-
Form D
Online Background Check Process
To be completed by ALL volunteers ONLINE
Online Instructions
Have your social security number handy; this will take one minute to complete.
For the Applicant:
1.
Log on to https://NorthStarYouthExchange.volunteerportal.net
2.
Review text on the Welcome Page, enter the password: NorthStar and
click “I Agree”.
3.
Enter Personal Information.
All fields marked with a “*” are required.
4.
Click “Next”
5.
Review all information to ensure its accuracy before proceeding.
If you need to make any corrections you can click on the “Edit” link or the
“Previous” button to return to the Personal Information page.
6.
Click “Complete” to process your search.
***Please Note the following***
If you Quit without clicking Save, the system will not save your information. Your
background check will not be run. You will need to start over from the beginning when you
return.
If you click Save before you Quit, you will be provided with a reference code to enter when
you return to the site to pick up where you left off.
When returning to the site, click on this link on the Welcome Page: “If you are returning to
finish a previous search, then click here.”
Enter your last name and reference number to resume your previous search.
The results of the background check will be communicated to the Rotary Club Contact by the
District Youth Exchange Representative.
-23-
Youth Exchange Supplies Order Form
Requested by
Rotary Club of
Address
________________________________________________________
________________________________________________________
________________________________________________________
________________________________________________________
Telephone
____________________________ Fax________________________
E-Mail
________________________________________________________
The following items are available from the North Star North Star Office. Please indicate
quantities when ordering:
____ Outbound Application Packet - Writable application forms are downloadable
from our website: www.northstaryouthexchange.com
(Click on “Prospective Students,” then “Application.”)
____ North Star Youth Exchange Post Cards
____ North Star Youth Exchange Poster
____ North Star Youth Exchange Outbound Promotional Brochure
____ North Star Youth Exchange Host Family Promotional Brochure
____ Guidelines for Host Families Brochure
____ Youth Exchange Program Host Parent Handbook
____ Form A - Youth Volunteer Affidavit, and Addendum Form A – Volunteer
Personal Reference Check(Form A)
____ Form B - Host Family Application
____ Form C - Host Family In-Home Interview forms
____ Form D – Replaced by online background check process. Please refer to
page 17 for the online instructions.
Send request to:
North Star Youth Exchange Office
11251 Red Fox Drive
Maple Grove, MN 55369
Phone: 763-553-1604 Fax: 763-550-0619
E-mail: diane.confer@comcast.net
Additional items are available from R.I. Headquarters:
Rotary International, 1560 Sherman Avenue, Evanston, IL 60201
Phone: 847-866-4600 Fax: 847-866-3276. Visit the website at www.rotary.org.
-24-
OUTBOUND
PROGRAM
STATEMENT OF CONDUCT FOR WORKING WITH YOUTH
Rotary International is committed to creating and maintaining the safest possible environment
for all participants in Rotary activities. It is the duty of all Rotarians, Rotarians’ spouses,
partners, and other volunteers to safeguard to the best of their ability the welfare of and to
prevent the physical, sexual, or emotional abuse of children and young people with whom they
come into contact.
Adopted by the RI Board of Directors, November 2002
Adopted by Multi-District 5950-5960 Rotary Youth Foundation, January 2006
Adopted by District 5950 District Assembly, April 2006
Adopted by District 5960 Assembly, April 2006
-25-
Calendar for Outbound Program 2013-2014
Timetable and Procedures
March - Rotary clubs schedule promotion programs in high schools and the community.
April – October - Youth Exchange promotion is conducted in schools, youth groups,
newspapers, direct mail, etc. Contact the Rotex president to schedule a speaker for your
Rotary club or high school (see Committee stationery for speaker ideas on page 2).
September – October - Outbound candidates submit completed applications to club.
Mid October - Local Rotary club interviews outbound candidates. Offer suggestions on
successful interviewing, questions, etc. (See sample interview questions in this manual.)
November 9 - Submit applications of all qualified candidates to the North Star Office.
Reminder: Also due by November 9 - Submit the Inbound Student Request Form and the
Club Certificate of Intent for Hosting an Inbound Student if you have not already done so.
These forms are located in the front (left) pocket of this manual.
November 11-15 - District appointments are made for final interviews with outbound
candidates.
Saturday, December 7 - District interviews are held. Final selection will be determined at a
subsequent meeting of the District Youth Exchange Committee (DYEC). The DYEC has final
approval of any and all youths selected for this program.
December 23 - All applicants and their sponsor club exchange officers are notified by mail of
the results of District interviews.
o Rule: A club may host a youth without sending a youth. A club is required to
host at least one inbound student when sponsoring one or more outbound
students.
o The applicant may be, but is not required to be, a son or daughter of a
Rotarian.
2014 Outbound Orientations Sessions for Candidates Accepted into Program
Sessions must be attended by outbound candidate and parents - Roseville Area Middle
School.
o Saturday, January 25, 2014 - First orientation session – 8:30 AM-2:30 PM
o Saturday, February 22, 2014 - Second orientation session – 8:30 AM-3:30 PM
o Saturday, April 12, 2014 -Third orientation session – 8:30 AM-2:30 PM
First Weekend in August ~ Welcome Home Celebration! – Rebound Orientation for
returning outbound students and their parents – first Saturday/Sunday in August.
-26-
Outbound Youth Exchange Program Costs
Cost to Sponsor Club:
Orientation fee per outbound student
(*Cost to sponsor clubs for sending an outbound is $150 per student
for one or two outbounds; free after that.)
$150*
Cost to Student:
Participation fee
$6,500
Includes:
Round trip transportation
Orientation sessions
Rotary blazer
Basic Insurance
Pins for exchanging
Business cards
Orientation materials
Name badge
Not included in the participation fee are costs of passport, visa, visits to
consulate, residency permit, language instruction, inoculations, gifts, local
travel, personal items. (Note: the fee is subject to change if there is a
significant change in airfare.)
Financial Assistance
A program has been established by the Rotary Youth Exchange Committee to help pay
part of the Youth Exchange Program fee for those students who demonstrate financial
need. Students may apply for financial assistance after they have been accepted into
the North Star Youth Exchange program. A grant application form will be included with
the acceptance packet that will be mailed to outbound candidates in early January.
-27-
Rotary Youth Exchange Program
Districts 5950/5960 Rotary Youth Foundation ~ MINNESOTA - WISCONSIN, USA
Cost of Participation 2013-2014 Rotary year (for 2014-2015 exchange year)
TO:
FROM:
SUBJECT:
Youth Exchange Applicants/Parents, Club Youth Exchange Officers
Rich Capp, Chair, North Star Rotary Youth Exchange Program
Student’s cost of participation in Rotary Youth Exchange Program
Cost of Participation in the outbound Rotary Youth Exchange Program for the 2013-2014 exchange year is $6,500.
Includes: Airfare - round trip, open ended ticket to host country
Rotary blazer
Basic overseas health/accident/death insurance
Orientation materials
Orientation sessions
Business cards, trading pins, name badge
Not included in the participation fee are costs of passport, visa or residency permit and related costs, in-country language
instruction, inoculations, gifts, local travel, personal items.
Payment Schedule - Payment is due in increments as follows:
• January 25, 2014 $2,100
• February 22, 2014 $2,200
The fee may be subject to change if there is a significant change in airfare.
• April 12, 2014
$2,200
Refund Schedule - Should the student discontinue participation in the program, the unused portion of the fee will be
refunded, dependent on time of withdrawal:
On or before January 25, 2014
Full refund
Between January 26 and February 22, 2014
Refund less $150
Between February 23 and April 12, 2014
Refund less $350
On or after April 13, 2014
Refund less $550
Refund will be issued when the following requirements have been met by the candidate:
• Issue a written statement, declaring that you are withdrawing from the Rotary Youth Exchange Program. Notify:
o The North Star Office – 11251 Red Fox Drive, Maple Grove, MN 55369; diane.confer@comcast.net
o Travel One (Attn: Linda Hindal, Riverview Office Tower #1500, 8009 34th Av. So., Minneapolis, MN 55425)
Lhindal@traveloneinc.com
o Your Country Officer
o Your Sponsor Club Youth Exchange Officer
•
If you have been provided with the Youth Exchange Blazer and Youth Exchange Trading Pins, they must be
returned to the North Star Office in new condition.
NOTE: If your airline ticket has been purchased: Any agent fees sustained will be deducted from your refund. If
it is non-refundable, the ticket amount and any associated agent fees will be deducted from your refund. Your
refund will be sent to you when the airline has credited our account with Travel One. This takes approximately
4-6 weeks.
Should it be deemed by the Youth Exchange Committee that the student is not a good fit for the program, the student’s
payment will be fully refunded, minus any incurred airline fees/costs, when the above requirements have been met.
Rich Capp, Chair
798 141st Avenue NW, Andover, MN 55303
B: 763-421-4102
E: capp.rich@gmail.com
Diane M. Confer, Exec. Secretary
11251 Red Fox Drive, Maple Grove, MN 55369
B: 763-553-1604
F: 763-550-0619
E: diane.confer@comcast.net
FINANCIAL ASSISTANCE may be available to the student, based on need. Determination of availability and amount of
assistance will be determined by the Youth Exchange Finance Committee. While in the exchange country, students will
receive a monthly allowance from the host Rotary club for miscellaneous spending.
-28-
Outbound Student Committee Responsibilities
1. Create interest within the community in the Rotary Youth Exchange Program. Rotex
is available to assist in this area. Refer to page 2 of this manual for names and
phone numbers of available presenters.
2. Children of Rotarians and non Rotarians are eligible to be Youth Exchange candidates.
3. Obtain student applications.
4. Interview applicants (see sample questions in this section). *more suggestions on how to
structure the interview time, who talks to the parents, etc
5. Rank and send complete applications (4 sets) of all qualified candidates to the Youth
Exchange Office by November 9.
6. Verify that four copies of the grade transcript and the Secondary School
Recommendation form have been sent to the North Star Office.
7. Verify that the student(s) and parents will attend the district interview on the first Saturday
of December.
8. Verify that outbound candidates and their parents will attend the three mandatory
Outbound Orientation Sessions and the Welcome Home Weekend. (electronic link?)
9. Keep in contact with your student throughout his/her year abroad.
10. PLEASE NOTE: A club may host a youth without sending a youth. A club is
required to host at least one inbound student when sponsoring one or more
outbound students.
-29-
Tips for the Club Youth Exchange Officer
Steps to Follow with an Outbound Student Candidate

Give the student the supplemental application packet to use as a draft. Final
application must be completed online: www.northstaryouthexchange.com. Click on
“Prospective Students,” then click on “Application.” Completed forms should be
returned to your club’s Youth Exchange Committee in time for the local interview.

Interview the students with a team of Rotarians. Interview all candidates by the end of
October.

Submit the applications of all qualified candidates to the North Star Office by
November 9. District interviews will be held Saturday, December 7, 2013.
When Submitting Applications to the North Star Office for District Interviews:

Send one (1) original and three (3) Good, clear computer generated copies to the
North Star Office; maintain one copy for the club files; and the student should keep
one copy for his/her records. Stress the importance of neatness and accurate spelling
to the applicant. The application should convey a favorable first impression. All
signatures must be original, and in BLUE INK, on at least one set.

Verify that one 2 x 2½” head-and-shoulders photo, and a set of original photos or
clear color copies, is affixed to each application.

Be sure to complete the sponsoring Rotary Club endorsement of the
application. The Club President and the Club Youth Exchange Officer or Club
Secretary must sign.

Inform applicants of the December 7, 2013 District Interview Day.

Verify that four copies of the grade transcript, Medical History and Examination form,
Dental Health and Examination form, and the Secondary School Report and
Reference have been submitted to the North Star Office or included with the
application.

Please inform applicants of the orientation dates (see Outbound Program Timetable in
this manual). Attendance is mandatory for all candidates and both parents. (In oneparent families, only the parent with whom the student lives is required to attend.) If
the candidate or parent has a conflict with this schedule, he or she must notify the
North Star Office in writing, prior to the interview.
-30-
Sample News Releases for
Seeking Outbound Youth Exchange Candidates
Sample News Release #1
Are you intrigued by the idea of spending one year residing in another country? Are you
fascinated by the prospect of living with another family, and learning about a new culture?
Do you enjoy meeting new friends with diverse backgrounds, sampling unique foods, and
experiencing adventures and numerous opportunities for growth?
If so, you may be interested in the Rotary International Youth Exchange Program. Rotary is
an organization of business and professional women and men united worldwide, who provide
humanitarian service, encourage high ethical standards in all vocations, and help build
goodwill and peace in the world. There are more than 34,000 Rotary clubs, with
approximately 1.2 million members.
Candidates for Rotary Youth Exchange must be between the ages of 15-19 at the time
departure (summer, year 20--), and be a freshman, sophomore, junior, or senior in high
school at the time of application. Students can NOT have turned 19 prior to the time of
exchange. Note: Some countries have age restrictions and may not accept older students.
Older students (18 and older) will have limited country choices.
Student must be in the top ½ of their class, and be involved in extracurricular activities.
If you would like more information, contact: (Rotarian) (Contact information) (Rotary club
name), or learn more at www.northstaryouthexchange.com. Applications are due (date).
Sample News Release #2
(Name)
Rotary Club to Host Youth Exchange Informational Meetings
Each year the Rotary Club of ________ sends students to foreign countries for the life
changing experience of spending a year attending high school and living with families in
another culture. They also host students coming to our community – most recently from
____________. Rotary sponsors the most US students going abroad of all exchange
programs and is the most affordable due to the tremendous support of Rotarians around
the world.
An informational meeting is planned for students and parents to learn more about this
wonderful opportunity to become a Rotary Exchange Student for next year! It will be held
(date, time, location). Representatives from the ______ Rotary Club will be there to
answer questions.
Applications are due ________ for students leaving for their exchange year in July or
August of 20_ _. Questions? Contact Rotary Club Youth Exchange Officer
_____________________________ or learn more at www.northstaryouthexchange.com.
-31-
Club Interview Rating Sheet
Student’s Name:
Age:
Sex:
Present school:
Grade:
Average:
Languages studied, and number of years:
Rating scale: 5 = Outstanding
4 = Very Good
3 = Good
2 = Average
1.
First impression (your reaction up to introduction)
2.
General appearance (neatness, poise, posture, etc.)
3.
Appeal (attractiveness of personality, manners, etc.)
4.
General attitude (enthusiasm, willingness, interest, etc.)
5.
Ability to express her/himself and think clearly (diction, vocabulary).
Does the student blurt out answers or give thoughtful ones?
6.
Knowledge of local, national and international affairs
7.
Ability to adapt and adjust (to others, to surroundings, etc.)
8.
Leadership potential (participation in school, church, and
community activities)
9.
Ambassadorship (will she/he be a good representative of her/
his country, community, Rotary, etc.?)
10.
Reaction of parents (supportive, keen on exchange program, etc.)
1= Poor
Total points
Overall rating:
Date:
Outstanding
Very good
Good
Average
Poor
Acceptable
Not acceptable
Ranking with
other applicants
Interview Committee member: _____________________________
Special notes (if any): _____________________________________________________
______________________________________________________________________
Rotary District 5080 Club Interview Rating/2002.09.01
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Sample Questions for Outbound Candidate at the Club Interview
1.
Why do you want to live in another country for a year?
2.
What are your future plans and ambitions?
3.
What are your most important personal accomplishments?
4.
How do you spend your spare time?
5.
Have you done any public speaking?
6.
Does criticism bother you? How do you respond to it?
7.
What would you do if you were hosted by people with opposite views to yours?
8.
What are your views on the use of liquor and drugs?
9.
Do you lose your temper easily? What happens when you do lose your temper?
10.
How would you describe your community to someone unfamiliar with it?
11.
Who is the current Mayor of your city or town council?
12.
What are the names of the last 3 US Presidents prior to the current one?
13.
Have you been away from home before? For how long?
14.
Did you get homesick? What did you do about it?
15.
How do you feel about being away from home for a full year?
16.
What do you consider to be your greatest strength?
17.
What do you consider to be your greatest weakness?
18.
If selected, what country would you most like to go to, and why?
19.
Are there countries that you would not want to go to and, if so, why?
20.
If asked to prepare a typical American meal, what would it be?
Rotary District 5080 2.5 Club Interview – Students/2005.09.05
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Sample Questions for Parents at the Club Interview
1.
How did your family first learn about the Rotary Youth Exchange Program?
2.
What is your understanding of your financial obligation under this program?
(Refer to applicable Youth Exchange Participation Fee letter.)
3.
Can your family afford this cost?
4.
Do you anticipate any major lifestyle changes while your daughter/son would be
away? (e.g. job change, move to another city or country, etc.)
5.
Is any member of your family seriously ill now? (e.g. aunts, uncles,
grandparents, etc.)
Would you expect your daughter/son to return home for the funeral of a family
member if a death occurred?
6.
Whose idea was it initially, that your daughter/son apply to become a North Star
Rotary Youth Exchange student?
7.
Are you 100% committed to your daughter/son going on exchange if selected?
If not, what concerns or reservations do you have?
8.
Would you intend to visit your daughter/son while she/he is on exchange?
If so, are you aware that you would require the permission of both the sponsor
and host Rotary Clubs to visit?
9.
Has your daughter/son provided our Rotary club with the names of two potential
host families for our inbound students? If so, is your family one of the two?
10.
Do you have ANY reservations or questions about the North Star Rotary Youth
Exchange Program?
If so, please tell us about them NOW!
Rotary District 5080 2.6 Club Interview – Parents/2005.09.05
-34-
INBOUND
PROGRAM
STATEMENT OF CONDUCT FOR WORKING WITH YOUTH
Rotary International is committed to creating and maintaining the safest possible environment
for all participants in Rotary activities. It is the duty of all Rotarians, Rotarians’ spouses,
partners, and other volunteers to safeguard to the best of their ability the welfare of and to
prevent the physical, sexual, or emotional abuse of children and young people with whom
they come into contact.
Adopted by the RI Board of Directors, November 2002
Adopted by Multi-District 5950-5960 Rotary Youth Foundation, January 2006
Adopted by District 5950 District Assembly, April 2006
Adopted by District 5960 Assembly, April 2006
-35-
Calendar for Inbound Program 2013-2014 (Tentative Dates)
September 7, 2013
Inbound Student, Host Family, Youth Exchange Officer
Orientation (1/2 day)
October 26-27, 2013
(Sat., Sun.)
Halloween Weekend for inbound students.
Hosted by the Rotary Club of St. Croix Falls/Taylors Falls
November 2, 2013
District 5960 Foundation Event
Prom Center ~ Oakdale, Minnesota
5960 Inbound Students’ participation to be determined.
No Foundation Event involving 5950 Inbound Students.
December 7, 2013
Country Fair ~ Inbound students promote the Youth
Exchange Program at Outbound Interview Session. Students
are to wear national costume or Rotary blazer, and be prepared
to promote their home country. No overnight.
January or February
2014
Inbound Orientation Session (1/2 day) for all January arrivals
and all of their host parents and host club exchange officers.
Exact date, time and location to be determined.
February 1-2, 2014
Winter Weekend for Inbound Students
Hosted by Rotary Club of Roseville
February 22, 2014
Inbound students assist with Outbound Orientation session at
Roseville Area Middle School; preliminary preparation for District
Conferences.
April 24-26, 2014
District 5960 Conference – National Sports Center,
Blaine Minnesota
All District 5960 inbounds participate
Attendance of students hosted in District 5960 is required.
(Exact date/time of inbounds’ participation to be determined)
May 2, 2014
District 5950 Conference – Radisson Blu Hotel,
Mall of America, Bloomington, Minnesota
All District 5950 inbounds participate
Attendance of students hosted in District 5950 is required.
(Exact time of inbounds’ participation to be determined)
June 14-15, 2014
A Valleyfair Adventure and overnight for inbound students.
Hosted by the Rotary Club of Shakopee
June 15-July 1, 2014
(Thursday-Saturday)
Summer Eastern States Rotary Trip for inbound students.
-36-
Inbound Student Committee Responsibilities
1. Obtain school signature/stamp or seal on Guarantee Form (part of student’s
application packet).
2. As required by the US Department of State, clubs must send the following information to
their inbound student, so it is received prior to the student’s departure from their home
country:
o A detailed profile of the first host family, stating whether the host family is a
permanent placement or a temporary arrival family.
o A detailed profile of the host school and community.
addresses of the host community and the local school.
Provide website
o Complete the online ID card (with information for the first host family) and send
to your inbound student and to the North Star Office.
3. Prior to the student’s departure from his/her home country, obtain from the student a
written travel itinerary. Send a copy to the North Star Office.
4. Provide a copy of the complete inbound student application to each vetted host family and
the high school.
5. Be sure someone from your committee meets the student at the airport.
6. Select a Rotary counselor for each inbound student. The counselor cannot be the Club
Youth Exchange Chair, or a member of the current host family.
7. Make arrangements for the student’s needs:
a)
$80.00/month allowance - miscellaneous expenses
b)
Pay for school lunch
c)
Transportation to Rotary events, inbound student programs (see Calendar for
Inbound Program Events) and club events
d)
Assist student in setting up a bank account
e)
Make copies of the student’s insurance policy, Certificate of Eligibility form (DS2019 visa document), return travel documents, and passport for each host
family and for your committee files.
f)
Do not take the student’s passport or other government documents from the
student unless the student requests your assistance for safe storage of these
documents. These documents must be in their possession or accessible to
the student at all times.
-37-
8.
Register student in local high school (see below).
9.
Arrange for return travel to home country, at least 6 months before departure.
High School Registration of Inbound Exchange Students
1.
Prior to the inbound student’s arrival, the host club youth exchange officer must
complete Sections D, E, F and G of the student’s Guarantee Form. Upon completion,
the Guarantee Form is to be returned to the North Star Youth Exchange Country
Officer.
2.
To comply with state regulations, the local high school must be contacted prior to the
exchange student’s arrival. Provide the school with a complete application, including
an English translation of the grade transcript.
3.
The student is to attend the same high school throughout his/her stay. Only under
very special conditions is there to be a change in schools, and that must first be
approved by the district committee.
4.
The North Star Rotary Youth Exchange Program is in accordance with the
standards of CSIET (Council on Standards for International Educational Travel).
The inbound students may or may not be eligible to participate in school extracurricular activities. This is at the discretion of the school and/or the State High
School Athletic Association.
5.
No more than 5 exchange students may be enrolled at the same time in one school,
unless the school has agreed, in writing, to the placement of more than 5 students.
-38-
Inbound Student Counselor Overview
1.
Counselor should be the same gender as the student.
2.
Counselor must be someone other than the Club Youth Exchange Officer or a
member of the current host family.
3.
Responsibilities include:
a) Be an advocate for student.
b) Support the student and make him/her feel part of the Rotary family.
c) Be the liaison between the student and Rotary club, host family, school, and
community at large.
d) Provide guidance and counseling to the student in matters such as choosing
classes, friends, and activities.
e) Assist the student in adapting to the culture and language.
f)
Contact the student monthly, as required by the U.S. Department of
State, and complete the Contact Schedule (in a pocket of this manual). First
contact must be in person. Keep up-to-date and on file for 3 years. Send copies
of Contact Schedule to the North Star Office by December 1 and when
student returns home. This is mandatory for U.S. Department of State reporting
requirements.
For students who arrive in January, the forms are due July 1 and when the
student returns home.
g) Listen attentively to the student ’s comments and concerns.
h)
Prior to the student’s arrival, forward the Welcome Manual from the
North Star Youth Exchange website (see Resources tab under Inbound Student.
Provide the student with general information about the host club and area,
including a list of contact information for people and organizations the student
can contact if he or she needs help, as mandated by the US Department of
State.
i)
Work with community and student ’s school to ensure that student is involved in
positive activities and community life, throughout the school year.
-39-
j)
Inform student about sexual abuse and harassment and create a
supportive atmosphere in which the student feels comfortable to discuss his or
her concerns.
k) Be aware of signs and symptoms of sexual abuse and harassment, and know
what appropriate actions to take.
l)
Annual Training:
Know the RI and district policy on abuse and harassment prevention.
Download the Training Manual and Leader’s Guide:
www.rotary.org.
Training is available on the North Star Youth Exchange website:
www.northstaryouthexchange.com/club-officers/.
1. 4-Module Training
2. Youth Protection
-40-
Host Family Traveling Binder
This binder should reside with each current host family.
First Page: Inbound Calendar from the YEO handbook
Tab 1: Inbound Student’s Full Application
Tab 2: Paperwork from the inbound student

Insurance Information with policy number and 800-number

Copy of travel documents

Copy of passport and DS-2019
Tab 3: Contact Information

Local contact information sheet (key Rotarians, school)

District contact information sheet (use the letterhead found in the YEO handbook)
Tab 4: Rules

Host Family brochure

Host Family Handbook

Travel rules from YEO handbook
Tab 5: School/Bank

Passwords to monitor school work

Password for bank account
Tab 6: Foods

What student likes, wants to try, allergies to food
Tab 7: Activities

Things-to-do-sheet from YEO Handbook

Families can record things they have done with the student

Student can include a wish list of things to do
-41-
Assignments of Inbound Exchange Students to Host Clubs
The district committee desires input from each club regarding exchange students
they prefer to host. We hope to be able to accommodate your first, second, third or fourth
choice. Kindly return the Inbound Student Request Form to the North Star Office by
November 9.
Inbound Orientation
We provide this mandatory orientation and training for inbound students and their host
families. It is recommended that one member of the club Youth Exchange Committee also
attend. The sessions will be held at Roseville Area Middle School, Roseville, Minnesota on
January 25, February 22, and April 12, 2013.
Address Changes
The U.S. Department of State mandates that each time an inbound student changes host
families, they must be notified within 10 days. Send this information to:
North Star Youth Exchange Office
11251 Red Fox Drive
E-mail: diane.confer@comcast.net
Maple Grove, MN 55369
Fax:
763-550-0619
Driver Training
In compliance with the Rotary International Program Rules and Conditions of Exchange,
inbound students may not take the Driver Education course offered in their high schools or
through a driver’s school.
Employment
US Department of State states, “Students may not be employed on either a full or part-time
basis but may accept sporadic or intermittent employment such as babysitting or yard work.”
Tax Information for Host Families
QUESTION: How much may a host family deduct from their taxes for hosting an exchange
youth, and under what circumstances? (federal and state)
ANSWER:
$50 for each month that the family hosts the exchange youth and the youth is a
full-time student. Hosting for 15 days or more in a month is considered as
-42-
hosting for a full month. Families may deduct $50 for each summer month
when there is no school provided that they hosted the exchange youth during
at least one school month. Families that host exchange youths only during the
summer months when there is no school may not claim the $50 deduction for
such hosting. There should be a written agreement between the host family
and the host Rotary club for the hosting of the exchange youth.
SOURCE:
IRS Publication 526 and IRS Income Tax Regulations 1.170A-2.
Rotary Sponsored Trip: Summer Eastern States - June 15-July 1, 2014
A summer tour via bus is planned for inbound students. The trip includes a number of stays
en route to New York, Disney World, and Washington, D.C., including a visit to our nation’s
capitol and the White House. A brochure will be mailed to students and exchange officers in
November. Please encourage the inbound students to make their reservations early to
ensure accommodations. The cost of the tour in 2013 was $2,800. There will be an increase
in 2014. The student should also have a minimum of $400 for food and miscellaneous
expenses. This cost is to be paid by the inbound student, though your Rotary club may
choose to assist financially.
Travel with Host Families and Rotary Families
Travel with host families and Rotary families is permitted. However, telephone numbers and
destination location must be provided to the host Rotary club representative in case of
emergency.
Prior to any travel outside the United States, the requirements in the “Travel to Another
Country” section (below) must be met.
Travel to Another Country
Travel that includes leaving the United States requires the signature of the District
Responsible Officer for the Department of State on the Certificate of Eligibility for
Exchange Visitor (J-1) Status form (DS-2019), which is part of the student’s visa.
(see sample in Appendix).
The original DS-2019 should be presented to the Responsible Officer for his signature at
least two weeks prior to the beginning of travel. Mail or hand-deliver to: Allen L. Gerdin,
Responsible Officer, 5925 Forestview Lane N., Plymouth, MN 55442 (763-350-8699)
algerdin@att.net
Additional Visa May Be Required to Travel Outside of USA
Inbound students traveling with host families to Canada or Mexico may need a visa to enter
these countries. Refer to the following websites for information pertaining to these countries:
-43-
Mexico:
Canada:
www.inm.gob.mx/index.php/page/paises_visa/en
www.cic.gc.ca/english/visit/visas.asp
Host families planning to take their inbound students to a country outside of the USA should
check with the respective embassies for status changes in visa regulations.
Rules for Unaccompanied Travel
1.
The student must demonstrate that he/she is reliable, trustworthy and doing well in
school before any consideration will be given to independent travel arrangements.
Students are required to attend school, so travel is to be limited to school vacations,
unless permission has been given by the Youth Exchange Chair.
2.
Travel may be granted to visit adult relatives only.
3.
The completed Unaccompanied Travel Permission Form must be submitted by the
host Club Exchange Officer to:
North Star Office, 11251 Red Fox Drive, Maple
Grove, MN 55369 (Fax: 763-550-0619; Email: diane.confer@comcast.net)
Permission will be granted only if all required signatures are obtained:
Natural parents
District Country Exchange Officer
Host parents
District Youth Exchange Chair
Host Rotary Club Representative
4.
Travel must be by the most direct route possible.
5.
Student must be met at the terminal in the city to which he/she is traveling.
6.
Student must abide by North Star Rotary Exchange rules at all times.
-44-
Unaccompanied Travel Permission Form
1)
2)
3)
4)
5)
Club Exchange Officer must complete this form and obtain all signatures before
mailing the request.
Return all completed, signed form(s) to: North Star Office, 11251 Red Fox Drive,
Maple Grove, MN 55369, at least 2 weeks before anticipated departure. You may
email forms to: diane.confer@comcast.net
Permission to travel is granted when all signatures have been obtained. Final
authority rests with the District Youth Exchange Chair.
If permission to travel is denied and a non-refundable travel ticket was purchased, the
purchaser will sustain the financial loss.
All signatures do not have to be on one sheet. To expedite the process, duplicate this
form and send copies to all persons whose signatures are required. A signed letter
from student’s natural parents may be substituted for their signature on this form.
Student’s name:___________________________ Phone #:________________________
Host family name:__________________________________________________________
Host family address:________________________________________________________
Host Rotary Club:___________________________________________________________
Person(s) to be visited: ______________________________________________________
Relationship to student: _____________________________________________________
Complete address: ________________________________________________________
Phone # day: ____________________________ eve: ____________________________
Purpose of visit____________________________________________________________
Provide complete itinerary; Use additional sheet if necessary: ________________________
________________________________________________________________________
_________________________________________________________________________
Flight information - indicate plane changes, if any, and city:
Departure: City
Date
Time
Airline
Flight #
Arrive at
Return:
The undersigned hereby grant permission for unaccompanied travel:
_________________________________ __________________________________
Natural parent(s)
_________________________________ __________________________________
Host Parent
Host Club Representative
_________________________________ _________________________________
North Star Rotary YE Country Officer
North Star Rotary YE Chair
Submit form(s) to North Star Office ONLY after all signatures have been obtained
-45-
Time
Inbound Student Costs to Host Club
The host club’s share of costs for each inbound student’s Youth Exchange Program activities
is $400. This includes the student’s participation in the Inbound Orientation, Halloween
Weekend, Country Fair, Winter Weekend, District Conference, Valleyfair Adventure and
Overnight, and cost of conducting required host family background checks.
Total cost billed by district:
$400
An invoice will be sent after the student’s arrival.
Additional costs to club for each inbound student:
Monthly allowance ($80.00/month)
School lunch
$960
$100/month estimate
The Rotary club should budget for all host family
members to attend the Youth Exchange banquet
at the District Conference.
$30-$50 per person estimate
Other possible costs for Inbound Students, at host club discretion:
Christmas gift
Yearbook pictures
Birthday gift
Yearbook purchase
Graduation gift
School athletic jacket
Prom expense and/or assistance
Eastern States Trip expense assistance
(e.g. borrow formalwear, etc.)
Gift at departure
Monthly Financial Support
The host club is to provide each of its inbound students their school lunch, plus
$80.00 per month for spending money. It is important that all students receive the same
amount for their monthly allowance ($80). Your club is encouraged to give your inbound
student special gifts for birthday, holiday, graduation, and departure.
NOTE: Clubs are not allowed to make monetary payments or other incentives to host
families.
-46-
HOST FAMILY
SECTION
STATEMENT OF CONDUCT FOR WORKING WITH YOUTH
Rotary International is committed to creating and maintaining the safest possible environment
for all participants in Rotary activities. It is the duty of all Rotarians, Rotarians’ spouses,
partners, and other volunteers to safeguard to the best of their ability the welfare of and to
prevent the physical, sexual, or emotional abuse of children and young people with whom they
come into contact.
Adopted by the RI Board of Directors, November 2002
Adopted by Multi-District 5950-5960 Rotary Youth Foundation, January 2006
Adopted by District 5950 District Assembly, April 2006
Adopted by District 5960 Assembly, April 2006
-47-
Host Family Committee Responsibilities
The goal of this committee is to find, vet and prepare families to host an inbound student
during a one-year exchange.
The first step is to find good families. Please read Tips on Finding Host Families (page 45).
Once you have an interested family, it’s time to vet them.
What can you give a potential host family? A potential host family can receive a copy of
the inbound student’s letter and the parent’s letter. All identifying information must be blacked
out. You may provide: gender, first name, country, interests, age, dietary restrictions, and
special medical needs.
Vetting a Potential Host Family
There are five forms that must be completed for each potential host family:
Form A: Youth Volunteer Affidavit (green)
Form A Addendum: Volunteer Personal Reference Check (white)
Form B: Host Family Application (blue)
Form C: Host Family In-Home Interview Form
Form D: Background Check – to be completed online (see page 17)
There is a packet of these forms in this manual. Additional forms can be ordered through the
North Star Office: 763-553-1604.
Each person 18 and older living in the house during the exchange student’s stay with the
family must complete Forms A and D. Form A must be returned to the club Youth Exchange
committee. Form D (background check) must be completed online.
Once Form A is returned to your club, it’s time to conduct two reference checks. The
references are listed on Form A. Use Form A Addendum to take notes while talking to the
identified references.
Form B, the Host Family Application, must be completed by the potential host family and
returned to your club. If the answers are satisfactory to your club, schedule an in-home
interview when all family members will be present.
The in-home family interview (Form C) must be conducted by two Rotarians, at least one of
whom must have completed the Department of State training (see page 8). After all questions
are answered, each parent and both Rotarians must sign the bottom of Form C. Leave the
brochure GUIDELINES FOR HOST FAMILIES. Photos must be taken of the:
Home exterior and grounds
 Kitchen
 Student’s bedroom
Family/living room
 Bathroom
The North Star Office must receive the top copy of each of these forms (A, Addendum, B,C).
Read the instructions at the bottom of each form to determine who should receive the various
copies. The North Star Office must also receive a set of the photos.
-48-
When Is a Family Vetted?
A family is vetted when:
1. All 5 forms have been completed and your Rotary club’s standards have been met,
and;
2. Each person 18 and older living in the home when the student will live there has
passed the background check (you will receive an email stating if they passed or
didn’t pass).
After a Family is Vetted
Once vetted, present the first host family with the Host Family Traveling Binder. This is a 3ring binder created by you, containing a complete copy of the inbound student’s application
and other items listed in the Host Family Traveling Binder document in the appendix of this
manual. This binder will move from family to family along with the student.
Encourage the host family to contact their student via email.
The host family should pick up the student upon arrival at the Minneapolis-St. Paul
International Airport. A member of your Rotary club should also be at the airport.
Note: After reviewing the application, a vetted host family may decide that they don’t want to
host this student. If this occurs, let them know that they may apply to host another student
in the future.
Things to Do While the Student Is Living with a Host Family
Contact must occur between the Rotary club and the host family on a monthly basis.
Please record these contacts on the CONTACT SCHEDULE.
There must be one in-person contact with each host family.
An additional visit to the host family home is required. Within the first two months of
placement into a home, a Rotarian other than the two that interviewed the family must stop
by the home to make sure all is well.
All other monthly contacts with the host family may be via phone, email or in-person.
-49-
Tips on Finding Host Families
(Finding host family happens all year long…not just when you receive the application.)
As soon as you receive the application of your new inbound student, it’s time to tell others
about him/her. It’s best to have information to give to prospective families, but with the strict
guidelines from the Department of State, you cannot give an entire student application to a
potential host family until they have been vetted. Therefore, make many copies of the
inbound student’s letter and the natural parents’ letter, blackout the family’s last name and
any other contact information, and make this your handout. This cannot contain any photos
or contact information of the student.
Your goal is to find three host families (each would host four months) and have a fourth
family ready-to-go for any temporary placement that may be needed.
Sources of potential host families include:
High school counselors and language teachers
High school international clubs
Friends of your outbound student
Past outbound students’ families
Past host families
*Vicki will provide more here or link to other writings about finding host
families.
Your outbound student can be encouraged to identify potential host families. Some clubs
even mandate that their outbound student provides the three host families.
Personality Traits of a Host Family





Active
Social
Outgoing
Friendly
Curious about the world
Who Can Host
1. A couple with or without children.
2. A single parent with children in the home.
3. A single adult without children in the home can host if a Rotarian other than the one
that recruited and selected the applicant conducts a secondary review of the
application to ensure an adequate support network exists, and both the exchange
student and his/her natural parents agree in writing in advance to the placement.
Who Cannot Host
1. The club Youth Exchange Counselor cannot host the inbound student he/she is
mentoring. If they should desire to host, another person in the Rotary club must be
appointed to assume the duties of Counselor to the inbound student.
2. Any family receiving financial needs-based government subsidies for food or
housing which are necessary to meet basic living needs cannot host a student.
3. A relative of the inbound student cannot host this student.
-50-
Benefits of Hosting an Exchange Student
Don’t forget to mention the benefits of hosting a student while you are looking for families:
Family will learn about a new culture.
Family will learn new words and phrases in a different language.
The family will develop a lasting friendship with this student and his/her family.
The host family may visit sights and events with the student that they would’ve
overlooked if the exchange student hadn’t been in the family home.
5. Hosting a student may provide incentive to the children living in the host family to
learn a new language or consider being an exchange student themselves.
6. Family will have the support and appreciation of the host Rotary club and district.
1.
2.
3.
4.
Nice Things to Do for a Host Family
Your club will be asked to pay for each host family’s meal at the District Conference.
Information will be sent to you about this.
Invite the host family to your meeting when their inbound student is making their
presentation.
Invite all host families to one of your meetings when it is time to bid farewell to your student.
Be sure to recognize and thank your families in front of your fellow Rotarians.
Post-Exchange Evaluation Forms
The Council on Standards for International Educational Travel (CSIET) requires that postexchange evaluation forms be given to students, parents, and host families. These forms
follow in this manual. They may also be downloaded from the Youth Exchange website:
www.northstaryouthexchange.com.
Copies of the form are in the left pocket of this manual, or may be downloaded from the
North Star website: www.northstaryouthexchange.com. Click on the Host Families tab,
then Resources.
After completion, these forms should be returned to:
North Star Youth Exchange Office
11251 Red Fox Drive
Maple Grove, MN 55369-6328
diane.confer@comcast.net
Fax: 763-550-0619
-51-
Host Family Checklist
Use the checklist below as you vet each host family:
Step 1:
___ Each household member over 18 completes Form A: Youth Volunteer Affidavit
___ Each household member over 18 completes Form D: Waiver/Consent/Release
___ YE Committee member calls references, makes notes on Addendum Form A
___ Top page of Form A is sent to North Star Office
___ Top page of Addendum Form A is sent to North Star Office
___ Top page of Form D is sent to North Star Office by potential host family member(s)
Step 2:
___ Host family completes Form B: Host Family Application
___ Application returned to club YE committee
___ If answers are satisfactory, schedule an in-home visit
Step 3: In-home interview
___ Schedule in-home interview at a time when all household members are available
___ Interview must be conducted by two Rotarians
___ Interviewers use Form C: Host Family In-Home Interview Form
___ Interviewers must take photos of:
• Home exterior and grounds
• Kitchen
• Student’s bedroom
• Bathroom
• Family room or living room
___ Top page of completed Form C must be sent to the North Star Office
___ Send photos to the North Star Office electronically or via mail. If sending
electronically, specify in the subject line: Photos/rotary club/family last name
Step 4: A family is fully vetted when…
___ All forms are completed
___ Information gathered from the host family application and in-home interview meets
your club’s standards
___ Each adult in the home passes the criminal background check
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Step 5:
___ If vetted and approved, host family is allowed to see the complete student application
___ Each host family must undergo host family training either provided by the district or
the club YE committee
Step 6: Maintain contact with host family
___ After the student moves into the house, maintain monthly contact with host family.
___ Perform in-home visit within two months of student’s arrival in each home
• Visit cannot be made by the interviewing Rotarians
• The visit is to verify that the house is as described in the interview
• Tip: use this visit as a way to thank the host family for hosting the student
___ Record all contacts on the Contact Schedule
• Contacts with the host families and students may be recorded on the same or
Separate Contact Schedule forms.
___Send copies of Contact Schedule to the North Star Office by December 1 and
when student returns home. This is mandatory for U.S. Department of State reporting
requirements.
• For students who arrive in January, the forms are due July 1 and when the
student returns home.
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APPENDIX
STATEMENT OF CONDUCT FOR WORKING WITH YOUTH
Rotary International is committed to creating and maintaining the safest possible environment
for all participants in Rotary activities. It is the duty of all Rotarians, Rotarians’ spouses,
partners, and other volunteers to safeguard to the best of their ability the welfare of and to
prevent the physical, sexual, or emotional abuse of children and young people with whom they
come into contact.
Adopted by the RI Board of Directors, November 2002
Adopted by Multi-District 5950-5960 Rotary Youth Foundation, January 2006
Adopted by District 5950 District Assembly, April 2006
Adopted by District 5960 Assembly, April 2006
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Eden Prairie AM RYE SAMPLE CALENDAR
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Eden Prairie AM RYE SAMPLE CALENDAR (continued)
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Sample Inbound Student ID Card
This document is available in a writable PDF on the Youth Exchange Website:
www.northstaryouthexchange.com
Front side
North Star Rotary Youth Exchange
Districts 5950/5960
Inbound Student ID Card
Student: __________________________________________________
Signature: _________________________________________________
Birth Date: Year: ___________ Month: ___________ Day: __________
Home Family: ______________________________________________
Home Address: ____________________________________________
E-mail:____________________________________________________
Phone: ___________________________________________________
North Star Youth Exchange Office:
US Department of State:
US Department of State Email:
LOCAL POLICE:
763-553-1604
1-866-283-9090
jvisas@state.gov
911
Insurance Company:_________________ ______________________
(Phone)
Policy Number:_____________________________________________
School Name:_______________________ ______________________
(Phone)
Counselor:_________________________ ______________________
(Phone)
Back side
Host Club:_________________________________________________
Club President: _____________________ ______________________
(Phone)
Club YEO: _________________________ _______________________
(Phone)
District YEO:
Rich Capp
Phone: 763-421 -4102
798 – 141st Avenue NW, Andover, MN 55303
1st Host Family: _____________________ ______________________
(Phone)
Address: __________________________________________________
2nd Host Family: _____________________ _____________________
(Phone)
Address: __________________________________________________
3rd Host Family: _____________________ ______________________
(Phone)
Address: __________________________________________________
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Sample Outbound Student ID Card
This document is available in a writable PDF on the Youth Exchange Website:
www.northstaryouthexchange.com
Front side
North Star Rotary Youth Exchange
Districts 5950/5960
Outbound Student ID Card
Student: __________________________________________________
Signature: _________________________________________________
Birth Date: Year: ___________ Month: ___________ Day: __________
Home Family: ______________________________________________
Home Address: ____________________________________________
E-mail:____________________________________________________
Phone: ____________________________________________________
Host Country Rotary Contact: ________________________________
US Consulate in host country:________________________________
LOCAL POLICE:____________________________________________
Insurance Company:_________________ ______________________
(Phone)
Policy Number:_____________________________________________
School Name:_______________________ ______________________
(Phone)
Counselor:_________________________ _______________________
(Phone)
Back side
Host Club:_________________________________________________
Host Club President: _________________ ______________________
(Phone)
Host Club YEO: ____________________ _______________________
(Phone)
Host District YEO: __________________ _______________________
(Phone)
1st Host Family: _____________________ ______________________
(Phone)
Address: __________________________________________________
2nd Host Family: _____________________ _____________________
(Phone)
Address: __________________________________________________
3rd Host Family: _____________________ ______________________
(Phone)
Address: __________________________________________________
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Host Family Traveling Binder
First Page: Inbound Calendar from the YEO handbook
Tab 1: Inbound Student’s Full Application
Tab 2: Paperwork from the inbound student

Insurance Information with policy number and 800-number

Copy of travel documents

Copy of passport and DS-2019
Tab 3: Contact Information

Local contact information sheet (key Rotarians, school)

District contact information sheet (use the letterhead found in the YEO handbook)
Tab 4: Rules

Host Family brochure

Host Family Handbook

Travel rules from YEO handbook
Tab 5: School/Bank

Passwords to monitor school work

Password for bank account
Tab 6: Foods

What student likes, wants to try, allergies to food
Tab 7: Activities

Things-to-do-sheet from YEO Handbook

Families can record things they have done with the student

Student can include a wish list of things to do
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Sample Email Communication to Incoming Inbound Student
Dear (student’s name) and (name of student’s family),
I am the Youth Exchange Officer for the Rotary Club of Mankato, Minnesota
(http://www.mankatorotary.org/). In case you have not learned already, you will be living here
beginning in August. WELCOME!!
Mankato is a community of about 50,000 (http://www.mankato-mn.gov/) people located about 80
miles (130 km) southwest of Minneapolis-St. Paul, a very cosmopolitan city of several million. We
are indeed very far north, 40 degrees north, and winter is very, very cold relative to what you are
used to. We have all four seasons of the year. You will arrive in mid-August and summer will be
wonderful. During the fall you can buy or borrow clothing items here to keep you warm in the
winter… you might even take up skiing or ice skating! There are many, many community events
(http://www.greatermankatoevents.com/) so there’s never a shortage of things to do. Mankato is
home to is a medium sized state university, where I am a professor of geography, that has many
cultural events that you might enjoy (http://www.mnsu.edu/).
Our plan is for you to live with three different families for 3.5 months each during the 10 months or
so that you are here. We are still working on exactly which families, so I am not able to tell you who
they are yet as they have not yet been confirmed.
There are two public high schools in town, not so creatively named Mankato West and Mankato
East. You will attend whichever school your first family lives closest to. For the past two years our
students have attended West
(http://www.mankatowest.org/se3bin/clientschool.cgi?schoolname=school309). Each school has
about 300 students per grade, grades 9-12, that’s 1,200 or so on campus. Classes begin
September 9th. The school day starts about 8:00 AM and ends about 3:00 PM but you may choose
to participate in activities after school such as band, tennis or something else. Please plan to arrive
in Minnesota at least two weeks in advance of school beginning, three would be better, so that you
have time to learn a bit of the culture, the place and your host family. So, please make
arrangements to arrive August 20th… two or three days before or after is OK given air fares
and your own family logistics. You want to fly to Minneapolis/St. Paul (MSP) international
airport and we’ll come and meet you.
I can tell you a bit about our Club, its Youth Exchange Committee members and Rotary
Counselors. Our club has about 90 members, we meet Wednesdays at noon for lunch and our
Youth Exchange Committee includes myself and a woman named Patty Christiansen
(spc2w@aol.com). We also have two Rotary “Counselors” who are not members of the Club, Ron
& Lisa Browne (mankatobrownes@gmail.com). My job, with the help and advice of Patty, Ron &
Lisa is to do most of the organizing, logistics and paperwork related to your stay. Patty fills in when
I’m not available and is very good at being a resource for you as well. Ron and Lisa’s job as
counselors is to provide a safe place for you at any time in case there are difficulties or
uncomfortable situations with school, host family or anyone or anyplace else… something like a
really trusted aunt and uncle that you can share anything with and visit with every week or two,
even if just a phone call. Recently we’ve had boys as exchange students and Ron has taken a lead
role. He will take less of a role and Lisa will step up so that you have a woman as your main
counseling contact.
The Rotary District (http://www.rotary5960.org/) has an officer who works with all students from
Columbia, Laurie Pietila (laurie.pietila@gmail.com), you may have already corresponded with her,
I’m not sure. Her job is to make sure I have all information from the district regarding activities for
all students. I’m sure Rotary is beginning to work with you and your family regarding medical
insurance and all such logistics… all that will work out, just follow the procedures and directions.
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Myth Busting!
By Vicki Dilley, Rotary Club of Northfield, MN
• Clubs can’t afford to do Youth Exchange
Club membership increases because of Youth Exchange new energy comes into the
club bringing new ideas, new areas of expertise which brings financial growth.
Without, the club can stagnate.
• Clubs can’t find host families
This is absolute fact when you believe it. Your attitude, your communication, your
ability to “see” host families will insure that there are no host families available. Host
families are all over and when you start seeing them, you will be amazed at how easy
it is to get them involved. Check your attitude and the way you communicate…
Sub-Myth: Host families have to be Rotarians: No way, this is the beauty of
it all; anyone qualified can be a host family whether they are a Rotarian or not.
It is a great way to recruit future Rotarians!
• The schools don’t want to be involved in Youth Exchange
Not everyone’s experience…have your school principal or superintendent talk to
another towns school leaders that embraces this as a wonderful part of their
education program. They will tell you that they are disappointed that each school is
capped at 5 Rotary students per year.
• Students are not interested in Youth Exchange
Get a Rotex student to come to talk to your schools student body…share the success
stories. Don’t get stuck on the 1% that did not work out perfectly. We have a gold
mine of stories with our Rotex and we should be sharing their stories…talk about
changed lives, Minnesota/ Wisconsin students that became world citizens and are
intensely interested in World Peace and Understanding!
• Families can’t afford to do Rotary Youth Exchange, we are in a tough economy
How much does it cost to keep your student at home? Gas, car insurance, food,
entertainment, education, etc…I would suggest that you will save money sending a
student abroad. How do measure what they gain from the experience? Perhaps
because of their year abroad they will test out of a language, receive college credit for
their time, receive a scholarship or grant because of their uniqueness to the institution
or even be lead into a job or passion because of this year’s development in their life.
Priceless.
There are other myths beyond just the ones listed above; these are just the ones we hear
most often.
It is time to do some myth busting and really get behind this worthwhile program!
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Why Do Youth Exchange
North Star Inbound Student’s Speech
to Attendees at the 2011 District Conference
522. This must be the approximate number of times I started this speech over. I’ve got to
admit it; when I sat in front of this white paper, I had no idea where to start. Where should I
start when speaking about the most amazing year of my life? Where should I start when I
have so many people to thank? And where should I start to get 35 exchange students’
attention for more than 2 minutes?
The best answer I found was starting at the beginning. I’m pretty sure that during the last 8
months, all the exchange students around the world felt like they were pregnant. Going from
laugh to tears, from being motivated to being ready to give up, from thinking about taking the
next plane home to hopping that this year will never end. However, even after all that, I can
remember the most difficult day, and it happened to be the first one. On August 24 th, when I
was finally ready to get in the plane that would take me to the other side of the world, my
phone rang. I answered it, and what I heard made the last few steps to get into the plane the
most difficult I’ve ever have to take; my 10 year old brother had unintentionally called me
while playing on my mum’s phone. He didn’t say much, neither did I, but it’s what we
couldn’t say that was so strong. These steps that I had to take became the analogy of my
year abroad; if I could walk in that plane, I knew I would be able to do everything. And here I
am!
See, that’s the difference between everything we’ve ever known, and what the Rotary
provides us. Our parents since our youngest age told us how to act, to be polite, and say
please and thank you. Schools taught us how to learn, what to learn, how to fit in the
society. The Rotary? They asked us. The asked us “where do you want to go?” send us
there, and told us “Do whatever you want, experience by yourself, make your decisions, find
your own way! And follow the 4 D’s…”. The first thing I learned from them was that seeing
things differently, from another angle may be the answer. Since then, I celebrate differences
and that’s what I want to share with you today. It doesn’t matter who you are, where you are
or what you’re doing, our differences are what we must be most proud of. Do not try to fit in
a society, create your own. Create your society were skin color, religion, sexuality, gender,
look, IQ are differences that would be celebrated and not be falsely unseen. Only then
would we become a beautiful mosaic: different people, different beliefs, different yearnings,
different hopes, and different dreams. Too often did I see awesome people with awesome
accents trying to get rid of them to sound like everyone one else. Don’t do that… Your
accent is part of you, you are carrying your country with you when you speak, and I believe
that it is worth those few words you will never be able to pronounce…
(Thank you) for giving me the opportunity to travel the world; and…I would like to thank
Rotary International, and more precisely, every single club that opens their doors to
exchange students, every club counselor, every host family. Thank you to all the country
officers here, and everyone who is involved in making this year the most memorable year of
my life. I would also like to thank Rotex, you guys have been really patient with us and have
done an awesome job with everything. Thank you to my wonderful exchange students, you
changed my life forever. We still have to adventure through the East Coast together and I’m
really looking forward to be stuck in a bus for 17 days with all of you. Last but not least, I
would like to say happy birthday to my host dad. I think he’s turning 22 today, so have a
wonderful day!! Thank you.
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Sample Certificate of Eligibility for Exchange Visitors (DS-2019)
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A YEO’s Guide to the Database
North Star Rotary Youth Exchange is using a new database system to manage student
applications and contact information, including host family contact details.
This system has many overall benefits to North Star Rotary Youth Exchange, but direct
benefits to clubs include:
• Maintaining records of current and past host families -- which could aid the search for
potential hosts
• A Web application system that auto-fills club and district information into a writeable PDF
application -- a time-saver when preparing applications
• Keep track of student whereabouts, both inbound and outbound -- this will become the
standard for reporting student host family changes
With this system, club YEOs will be expected to:
• Maintain club president information
• Keep host family information current for inbounds
• Enter outbound applicants into the system
• Report any club YEO personnel changes to the North Star Office
Training will be provided at points throughout the Rotary year, in addition to this guide.
If you have questions on this database, or need help trouble-shooting, contact Lynn Keillor
at keill003@umn.edu or at 612-287-0869
Log In
1. Go to: http://database.rotary-yep.net/Login.aspx
2. Username: your e-mail address
3. Password
4. Click Login
Notes:
• If you can’t log in, or forget your username/password, contact the North Star Office,
Subject: Database login
Update My Personal Information
1. Click on “my account” in the left column
2. Insert new/updated information
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3. Home MD (multi-district) is “MD-NorthStar, United States”
4. Click “save” on bottom of page to update
Notes:
• This information is visible to North Star admin, country officers and Youth Exchange
Officers.
• This information can be updated by you at any time.
• Please fill in your complete and pertinent contact information. Whether you fill in nonessential information such as your birthdate or homepage is up to you.
• Club YEOs are designated as “club counselors” in the database. Club presidents are
designated as “student family.” Please think of this as an access level (medium for YEOs,
low for presidents) rather than your title. Every YE program has different nomenclature and
responsibilities for various YE roles; the creator of this database included.
Enter a Club President
1. Log in
2. Under "Admin" on left column, click on "user"
3. Under “select user type,” click on “student family”
Note: “Student Family” is an access level; it doesn’t mean that the president has to
host
4. Fill in the requested contact information and select gender
5. Click “save”
6. A pop-up box will appear with the new user’s contact information
Notes:
• If information in the left column is incorrect, please update it.
• If information in the right column is incorrect, contact the North Star Office with the
correct information. Subject: Database update request
Access/Update Student Host/Home Family/Club Contact Information - Inbound
and Outbound
1. Click on “Teams” in the left column
2. Click on “IN” or “North Star - IN” for the appropriate year
3. Click on the student’s name
4. Click on “Contact” on the top bar
5. A list of home and host contacts should appear.
Note: The dot next to a name means it’s the current contact and/or primary contact
person, ie: Natural parents may be listed separately, but the dot is next to the primary
contact. Three host families may be listed, the dot should be next to the current one.
Note: To enter host contact information, skip to Add Host Family Information section
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6. Click on a person’s name for his/her contact information. Update if necessary, and click
“save” at the bottom of the page.
Add/Update Host Family Information
1. Click on “Host families” in the left column
2. Click on the appropriate student name in the drop-down bar
3. All people in the database associated with that host club will show up in the left box
4. If the host family is in the left box, click on the name and click on “Add>>” to move to the
list
5. If the host family is not in the left box, click on “Add new host family,” located under the
left box. Enter the requested information.
6. To add/change dates to a host family, click on “Manage Periods” under the right box. The
host family list will appear. Adjust the dates by clicking “edit.”
Note: dates are kept in the European order of Day-Month-Year
7. To indicate a host family change, click on “Manage Periods” and click on the dot to the
right of the host family name to indicate that this is the current host family. Adjust dates as
needed.
8. Contact the North Star Office and let them know the student name and that host family
information has been changed/updated. Subject: Host family updated/Student Name
Send Prospective Outbound an Application
1. Click on “Student Applicant in left column
2. Click on “Outbound” at the top of the page
3. Enter requested information for student (e-mail address, first and last name)
4. Enter the club president e-mail address.
Note: if the club president is already in the system, the remaining information will
auto-fill into the blanks
5. Click “next”
6. In the new screen, click “Save and send link to web registration.” This will send an e-mail
to the applicant with directions on how to fill out the application.
Note: E-mail/call the student separately to ensure they received the login e-mail.
Spam filters can sometimes block this e-mail. The sender is “Rotary Youth Exchange” and
the subject is “Rotary Youth Exchange - Web Registration and Application System - Long
Term.”
7. If you’ve made a mistake, click on “<<Back”
8. If you want to send an application to another student, click on “Clear Data,” which will
bring you back to the prior page
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