FOREIGN EXCHANGE STUDENT ENTRANCE REQUIREMENTS
Pinellas County Schools
World Languages
www.pcsb.org
Application packets for the 2015/2016 school year are due in the office of World Languages by
July 15, 2015.
Please send to World Language Specialist
Or
Leticia Calhoun, Secretary
Pinellas County Schools
World Languages Department
301 4th Street S. W.
Largo, FL 33770
727-588-6072 (Secretary)
727-588-6066 (Specialist)
727-588-5185 fax
calhounl@pcsb.org
PLEASE NOTE: SCHOOL ASSIGNMENTS WILL NOT BE MADE
UNTIL THE MIDDLE OF MAY
Governor’s Sterling Award Winner
FOREIGN EXCHANGE STUDENT ENTRANCE REQUIREMENTS
Please find enclosed our board policy, health requirements, and checklist of requirements for
admission of foreign exchange students into Pinellas County High Schools.
Foreign exchange students will be assigned to a "zoned" school based on the address of the
host family, on a space available basis. Although foreign exchange students placed with a host
family that includes a high school student may request placement in the school assigned to the
host brother or sister, such placement cannot be guaranteed.
Upon receipt of all required
paperwork (see enclosed checklist) the Office of World Languages will work with the Student
Assignment Office to secure a school assignment. It is requested that copies of SLEP and/or
TOEFL test with scores, or other documentation of English Proficiency, be included in the
application. As soon as the school assignment has been verified, the exchange company will be
notified, and a copy of the student packet and the school acceptance form will be sent to the
school principal. This school principal will review the information and sign the acceptance letter.
This time of the year is very busy and this process takes approx. one week from the time they
receive the packet of information. Please allow them time to review before calling them to retrieve
the acceptance letter.
Please note that documentation of all required immunizations must be on the DOH Form 680 (Part
A), and included with the paperwork. Per the attached entrance requirements, the immunization
record is taken to the County Public Health Unit to be recorded on this form in order for the child
to attend school. A Temporary Medical Exemption, DOH Form 680 (Part B), to receive additional
shots, cannot be issued prior to the student’s arrival in this country. Therefore, any that are
needed should be given before the student leaves the home country.
All documents listed on the checklist, including an acceptance form to be signed by the principal,
are required and must accompany the exchange student’s application before being approved by our
office. It should be the responsibility of the agency to see that complete paperwork is included
with the application and sent to our office at least five weeks prior to the student’s arrival in this
country. This allows sufficient time for the supervisor of World Languages to contact the Student
Assignment Office in order to obtain the school assignment for the exchange student. Any
incomplete information will not be approved and could result in a delay in the acceptance of
the student.
Please note that, since board policy indicates that no new foreign exchange student will be enrolled
beyond the 10th day after the first day of school in the year, applications must be submitted at
least three weeks prior to the opening of school. No applications will be accepted in the second
semester.
Thank you for your cooperation, and we trust this information will be helpful in placing students in
Pinellas County Schools without delays. If you have any questions, please feel free to call the
Office of World Languages at 727-588-6072 or 727-588-6066.
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HEALTH REQUIREMENTS
Students registering in Pinellas County Schools through the Foreign Exchange Program are required
to have 1) a physical signed by a licensed physician and dated within one year prior to enrollment and
2) documentation of immunizations. The following immunizations are required:
1.
DTP – Five (5) doses required.
If the fourth dose of DTP is administered on or after the fourth birthday, a fifth dose
is not required. DT (pediatric) vaccine is acceptable if pertussis vaccine is medically
contraindicated.
Td (adult) vaccine (a series of 3 doses) is acceptable and recommended for children 7
years of age or older.
2.
Polio (OPV) – Four (4) doses required.
If the third dose of OPV is administered on or after the fourth birthday, a fourth dose
is not required. IPV is an acceptable alternative if OPV is not indicated. Polio vaccine is
omitted from the required immunizations of children 18 years of age or older.
3.
Measles, Mumps, and Rubella- for high school
MMR combined One (1) dose at 12 months of age or older
Measles Single One (1) dose at 12 months of age or older
Mumps Single One (1) dose at 12 months of age or older
Rubella Single
4.
One (1) dose at 12 months of age or older
Hepatitis B – Two (2) or three (3)* doses required.
* For students ages 11-15 only a 2 dose series of increased strength per dose given 4-6
months apart is available through Merck Pharmaceuticals.
All appropriate doses and dates must be entered. This immunization record should be taken to the
Pinellas County Public Health Unit to be recorded on the blue DOH Form 680 – Part A in order for
the child to attend school.
* History of disease is unacceptable for exemption from immunization.
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FOREIGN EXCHANGE STUDENT POLICY
PINELLAS COUNTY SCHOOLS
(As contained in Board Policy 5114)
APPLICATION
Once the initial application has been given approval by the Office of World Languages, t h e
sponsoring organization will receive notification of acceptance in one of sixteen high schools in the
district. All documentation required for application must be completed before a student will be
placed in a Pinellas County school. Students will be enrolled on a first come first served basis.
There is a limit of eight (8) foreign exchange students per agency. Not more than five (5) foreign
exchange students from any one agency may be placed in any one school. No student will be admitted
to Pinellas County Schools following the tenth day of any semester. As written in school board
policy, section 5114, "Foreign exchange students are admitted for a full academic year only. No
foreign exchange student shall be admitted following the tenth day of the first semester or at
any time during the second semester of any school year".
ENROLLMENT AND ORIENTATION
After the sponsoring organization has been given notification of acceptance, in writing, and a school
assignment has been made, a representative of the sponsoring organization, a member of the host
family, and the student will go to the assigned school to meet with the principal or his designee and
a counselor to complete the registration process and to receive appropriate orientation. Such
orientation shall be designed to acquaint the student with the American school and its environs and
with the Code of Student Conduct. Once comfortable in the school students are encouraged to
contact the world languages teachers to find out about participation in language clubs, honor
societies and multi-cultural activities.
REGISTRATION
The foreign exchange student shall be required to present an entry permit J-1 certificate of
eligibility at the time of registration at the high school.
GRADE PLACEMENT AND GRADUATION
Grade placement of foreign exchange students will be determined on the basis of each student’s
previous course work and the length of the program in the student’s homeland. Since foreign
exchange students normally return to their home country to complete one or two more years of
instruction at a secondary institution/gymnasium, these students cannot be classified as seniors in
the Pinellas County Schools.
Course enrollment of foreign exchange students and current interest shall be determined on the
basis of each student’s previous course work.
All foreign exchange students shall be issued an official transcript of completed courses upon
termination of their stay in Pinellas County.
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COMPLIANCE WITH POLICIES AND SUPERVISION
Each foreign exchange student is expected to comply with the policies of the Pinellas County
School board, including the Code of Student Conduct, and with all other legal provisions
pertaining to him. Repeated violations of the Board’s policies may result in the student’s
withdrawal from the school in which he/she is enrolled.
It is the sponsor’s responsibility to resolve any problems that may arise between/among
the student, the host family and the school, including, if necessary, the changing of the host
family or the return of the exchange student to his/her country, in the event any
differences cannot be reconciled. Sponsoring agencies are asked to first contact the school,
and then the Office of World Languages in the event that the host family changes any time
during the year-long stay.
The principal shall notify the local representative of the sponsoring organization of any
suspected neglect of the student on the part of the host family.
All school-related expenses for the student are the responsibility of the sponsoring
organization/host family.
ATHLETIC ELIGIBILITY
Students are governed by the Florida High School Activities Association rules and
regulations regarding participation in interscholastic athletics. For any foreign exchange student
who wishes to participate in interscholastic athletics, a letter indicating his/her foreign
exchange status shall be included with the principal’s annual eligibility list.
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FOREIGN EXCHANGE STUDENT
HOST FAMILY INFORMATION
FOREIGN EXCHANGE STUDENT:
Placement Grade:
Gender
M
F
Zoned School:
HOST FAMILY:
LAST NAME:
HOST MOTHER:
HOST FATHER:
HOME ADDRESS:
PHONE:
City/State
Zip
Family Information:
Host Mother’s Occupation:
e-mail:__________________________
Employer:
Phone:
Host Father’s Occupation:
e-mail:___________________________
Employer:
Children (include those not living at home):
Name
Phone:
Age
Sex
____
____
____
____
____
____
____
____
School
Name Activities and Interests of Family:
Host Mother’s Signature:
Date:
Host Father’s Signature:
Date:
BY SIGNING AS THE HOST FAMILY, I UNDERSTAND THAT THE STUDENT
MAY NOT BE ASSIGNED TO THE REQUESTED SCHOOL(S) AND ABIDE BY
THAT DECISION. I AGREE TO ACCEPT THE PLACEMENT MADE BY THE
STUDENT ASSIGNMENT OFFICE.
Please return this form with application
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FOREIGN EXCHANGE STUDENT CHECKLIST FOR ENROLLMENT
STUDENT’S NAME:
BIRTHDATE:
COUNTRY:
GRADE:
GENDER:
IN ORDER FOR THE OFFICE OF WORLD LANGUAGES TO PROCESS YOUR APPLICATION FOR THIS
STUDENT, PLEASE ANSWER THE FOLLOWING:
(CIRCLE ANSWER)
YES NO
This student, considered for placement in a Pinellas County high school under the Foreign
Exchange Program, is sponsored by a service club or a non-profit organization/institution
approved by the Council on Standards for International Travel (CSIET).
YES NO
The student is NOT a transfer student from an out-of-county or out-of-state high school.
YES NO
The J-1 certificate of eligibility (Form DS-2019) issued by the responsibility Officer of
his/her program will be presented to the school at the time of registration.
YES NO
The student is at least fifteen (15) years of age and not more than nineteen (19) years of age
on the date of enrollment in the program.
YES NO
The student has sufficient reading and speaking knowledge of the English language to be able to
successfully participate in regular high school classes. The student’s documentation of English
proficiency is attached. (Recommended: SLEP test results in the 75th percentile and/or TOEFL
score of 460 or higher.) Students will be tested to determine whether ESOL Services are
recommended.
Important note: All foreign exchange students will also be tested and must pass the district’s
English language proficiency assessment instrument.
YES NO
Pertinent information about the student, his family and host family is attached.
YES NO
2 Proofs of residency of the host family are attached. (This may be a utility bill for power,
water, cable, sewer, or land-based telephone (not cellular), or rental agreement or lease, or
closing document or tax statement with homestead exemption with host parent’s name and home
address on it.)
YES NO
A copy of the student’s official academic transcript with an English translation is
including a brief description of each course taken in grades 9-12 or level equivalent.
YES NO
Documentation of birth (a clear copy of the student’s birth certificate) is attached.
YES NO
A record of the student’s immunization and physical (signed by a licensed physician and dated
within one year) is attached.
YES NO
The student is registered for a full school year. (Please note th a t we do not accept
students on a half-year basis.)
Please return this form with the application
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attached
YES NO
An affidavit of adequate health insurance coverage is attached or will be presented
to the school at the time of registration.
YES NO
This student has NOT received a diploma from the home school. (If so, the student
must register in an adult program or college.)
YES NO
Placement of this student does not exceed the International Student Exchange
Programs (USIA) maximum of five (5) students sponsored by your agency in this
school.
PLEASE NOTE:
ALL REQUIRED DOCUMENTATION IS NEEDED BEFORE
A SCHOOL ASSIGNMENT CAN BE MADE.
FOREIGN EXCHANGE STUDENTS MAY NOT BE REGISTERED AS SENIORS AND,
THEREFORE, WILL NOT BE ELIGIBLE TO EARN A DIPLOMA
OR GRADUATE FROM A PINELLAS COUNTY SCHOOL.
SIGNATURE:
DATE:
TITLE:
PHONE:
LOCAL AREA AGENCY REP:
AGENCY NAME:
ADDRESS:
City/State/Zip
Phone Number:
E-mail Address:
Please return this form with the application.
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