Initial Application for Rotary Youth Exchange District 9670 Long Term Program The Applicant:

Transcription

1 See over for instructions on How to Apply Initial Application for Rotary Youth Exchange District 9670 Long Term Program The Applicant: Name Sex: Male/Female Address.. Postcode.. Telephone. Mobile Date of Birth State Electorate.. Parents or Legal Guardians: Fathers Name Address. Place of Birth.. Citizen of (country) Religion (optional). MLA... Federal Electorate MHR Mothers Name.. Address.. Phone. Mobile Phone Mobile.. Occupation.. Applicant's Siblings: Sex /Age /Occupation/Living at home? Occupation.. 1. Male/Female. Occupation.. Age Yes/No 2. Male/Female. Occupation.. Age Yes/No 3. Male/Female. Occupation.. Age Yes/No Do you have any relatives living abroad? (grandparents, aunt, cousin, etc) YES/ NO In which country? PARENTAL OBLIGATION We, the parents of the above named applicant, understand that we will be responsible to meet the Obligations of the Parents as outlined in Part G, in the Rotary District 9670 Australia Youth Exchange Program - GUIDELINES for APPLICANTS, which was attached to this Initial Application Form. Signed../../.. and../../. (Father/Guardian) (Date) (Mother/Guardian) (Date) Secondary School and Personal Information: Do you smoke? Yes/No Have you ever been involved with drugs? Yes/No Do you regularly drink alcoholic beverages in public? Yes/No Do you have a steady boyfriend/girlfriend? Yes/No. How often do you go out together?.. How much time do you devote weekly to school studies? (Homework, extracurricular activities).. Name and address of your School. Your current year.. When will you finish High School Number of students at the school... What international languages have you studied and for how long?.. How well are you able to speak and read those languages? What responsibilities have you had at school and in the community? (Clubs, offices, student counsel) If you have preferred countries for exchange, please indicate your preference: (select from the given list in the Guidelines document Part D) If there are any countries listed, to which you would prefer NOT to go, please state so here: Smile! Attach a good quality colour head and shoulder recent photograph about 5cms square 1. 2 Reasons.. Do you have any dietary restrictions? Yes/No If yes, please advise... Do you have any ongoing medical conditions Yes/No If yes, please advise... Signature of Applicant. Date././

2 HOW TO APPLY 1. Complete front page of the Initial Application form and sign 2. Complete the Youth Exchange Program Questionnaire as directed 3. Read the ROTARY DISTRICT 9670 AUSTRALIA YOUTH EXCHANGE PROGRAM GUIDELINES FOR APPLICANTS 4. Provide the request for a CONFIDENTIAL SCHOOL REPORT to your School Principal. 5. Send the following by 1 st April to: The Chairman Rotary D9670 Youth Exchange Program Committee Rylstone NSW 2849 The original and 2 photocopies of: o THE FULLY COMPLETED APPLICATION FORM o YOUR QUESTIONNAIRE RESPONSE o PHOTOCOPY OF YOUR LATEST SCHOOL REPORT o YOUR ID COLOUR PHOTOGRAPH (attached to page 1 - about 5cms square) NB: Please print/type the requested information CLEARLY using black ink. $50 APPLICATION FEE once your initial application is received the Treasure of : Rotary District 9670 Youth Exchange Program Committee Inc will invoice you using the address you supplied.

3 Rotary District 9670, Australia Youth Exchange Program Questionnaire Directions: Please give brief answers to the following questions. Type these answers using single spacing on no more than four A4 pages. Try to give some detail for each question response. Copy each question then type your answer directly below each question. Attach your answers to the Application Form. 1. What are your hobbies, cultural activities and sporting activities (eg. art, music, sports, etc.) Tell about your special interests in these areas. (eg. Why did you become interested? How long have you been interested? How much time do you devote to them?) 2. What are your future plans and ambitions concerning your education and career? Why have you chosen this path? 3. Write about any trips that you have taken outside of your country. (eg. Where? With whom? For what purpose? For how long? etc?) 4. We all dislike certain things, such as some kinds of food, certain animals, high places, certain treatment by other people, etc. List those things that you dislike. 5. List what you feel are your strong characteristics. 6. List what you feel are your weak characteristics. 7. Outline the subject you undertake at school and any other responsibilities you have had at school. 8. List in order of their importance, the four major issues that you think confront the world today. State your feelings on any one of these issues. 9. Write about the occupations of your parents (eg. What do they do? How big is the company in which they work? How long have they worked there? etc.) 10. Describe briefly your community. (eg. Location, population, economy, your community involvement and other factors.) Describe your home. (eg. Do you have your own room or do you share your room with others? Does anyone other than your parents and brothers and sisters live at home? Where in your home do you study? Where is your home in relation to your school?). 11. You will be expected to speak about your country in front of an audience. Please detail any speaking experience you have had before an audience. 12. What other information can you give to enable a better assessment to be made of your potential as an ambassador for your country (achievements, awards, skills). REMEMBER: Attach your answers to the Initial Application Form!

4 ROTARY DISTRICT 9670 AUSTRALIA YOUTH EXCHANGE PROGRAM CONFIDENTIAL SCHOOL REPORT This Confidential Report shall be used by The Chairman of the District Youth Exchange Program Committee, for the purposes of selecting candidates for, and administering the Youth Exchange Program. It will be destroyed upon the completion of the Exchange. Applicant s Name. Applicant s Home Address:.... Applicant s Home Telephone No... Mobile No PARENTAL RELEASE We, the parents of......, the applicant for participation in the Rotary International Youth Exchange Program, authorise and request the Principal to provide this Confidential Report to the Chairman, District 9670 Rotary Youth Exchange Program Committee as described herein. Signed: (Father)... (Mother). PRINCIPAL S REPORT Applicant s full name Applicant s present year in school Approximate place in year.. No. of students in the year List subjects studied with brief comments on ability, achievement and application.... Comment briefly on the Applicant s suitability for this exchange program and as an ambassador for his/her country School.. Address. Telephone No... Signed. Position Date /../ Please mail the completed Confidential School Report with envelope marked Confidential by 1 st April to: Chairman Rotary District 9670 Youth Exchange Program Committee Inc. Rylstone. NSW 2849

5 Rotary District 9670 Australia Youth Exchange Program Guidelines for Applicants The Rotary Youth Exchange Program is an educational and cultural exchange program. It provides for the selection and sponsorship of students in the 15 to 17 years age group to spend twelve months attending a secondary school and living with host families in another country. The following material is for the guidance of applicants and parents. Please keep this material for reference. A. Objectives of the Program - to enable students: To further international goodwill and understanding by studying first-hand some of the problems and accomplishments of people in lands other than their own. To advance their education by studying for a year in an environment different from their own and undertaking study courses and subjects not normally available to them in secondary schools in their own country. To broaden their own outlook by learning to live with people of cultures different from their own, and by having to cope with day to day problems in a different environment. To act as ambassadors for their own country by addressing Rotary Clubs, community organisations and youth groups in their host country and by imparting as much knowledge as they can of their own country, its problems and accomplishments, to the people they meet during their year abroad. To study and observe all facets of life and culture in the country where they are hosted so that on their return to their home country, they can pass on the knowledge they have gained by talking to Rotary Clubs, other community organisations and individuals. B. Who is eligible? Applicants should be between 15 and 17 years. Students must be in year 9, 10 or 11 in the year they make application. It is a requirement from the NSW Department of Education that students must return to secondary schooling education in Australia on their return from the exchange year. Applicants should have above average academic ability and be placed preferably in the top 30% of their year. Applicants must be of good character and reputation. They must have an out-going and pleasant personality to fit them for the role of an ambassador for Australia. Applicants should be prepared to accept discipline and be capable of adjusting to new and strange conditions. Sons and daughters of Rotarians are eligible for Rotary Youth Exchange but receive no special preference in selection. It is suggested that, where practical, these students should apply to Clubs other than the Club where they have a close relative. Applications can be considered from persons with hearing impairment or certain physical disabilities. C. Applications: Rotary Clubs are autonomous. Rotary Clubs usually decide in February/March whether or not to participate in the Rotary Youth Exchange Program which is to commence in the coming Rotary Year (1 st July to 30 th June). Participating Clubs will set their own interviewing of applicants.

6 Students are to submit their application with requested information to The Chairman of Rotary D9670 Youth Exchange Program Committee by 1 st April. The application fee of $50 is to be submitted with the application form. The fee will be refunded if the student is not selected to attend an interview at District level or if the student withdraws from the program prior to the District Interviews. If you are accepted and progress to a full application there is a further application fee of approximately $200. All applications must be made on the Initial Application Form available from D9670 website using clear black print. A copy of the Confidential School Report is attached to the Initial Application Form. After parental approval is recorded on the form, the applicant should request the School Principal or Year Advisor complete this report, and it should then be mailed directly to The Chairman of the Youth Exchange Program Committee. It would be courteous of the applicant to provide a stamped addressed envelope for the school s use. D. Selection: Selection is competitive, as the number of places available is limited. Suitable applicants may be granted an interview by the Rotary Clubs who receive their Application Form. These interviews are usually held in April of each year. Parents may be required to attend, but will not participate in the interview. An applicant who is successful at the Club interview will be required to attend a District Selection Interview, held at a place and time to be advised in writing by The Secretary of the District Committee. As parents are vitally involved in the exchange process, the attendance of at least one parent at the District Interview is essential, but the attendance of both parents is preferable. Following District Interviews, satisfactory candidates will be invited to a Selection/Assessment and Placement Day. Students only to attend this day. Members of the provisional outbound team will then be required to attend two residential briefing weekends to prepare them for their exchange year abroad. Students and at least one parent are to attend both briefing weekends. All briefings will be held at CB Alexander College, Tocal. This is north of Maitland near Paterson. Student attendance at all selection and briefing weekend sessions is mandatory to retain your place in the outbound student team. District Interviews are held in May and each applicant will be interviewed by the District Committee. The student will be advised in writing of their interview date, location and time. A sponsor Rotary Club representative is also encouraged to attend. Expenses associated with transport to the Selection/Assessment and Placement Day, and briefing weekends are the responsibility of the applicant. The Application Form allows applicants to indicate their preferred destinations from the available countries. Because of the limitations of the exchange opportunities available, it is not always possible to be placed within the countries selected. The Committee reserves the right to offer placement within any country in the exchange program. Countries that may be available include: Austria, Belgium, Brazil, Canada, Denmark, Finland, France, Germany, Italy, Japan, Netherlands, Norway, Poland, Slovakia, Spain, Sweden, Switzerland and USA.

7 E. Obligations of Rotary: The District Youth Exchange Program Committee has the obligation to select and adequately brief outbound students and to arrange for Rotary Clubs in another country to host each student for the year. The hosting Rotary Club will guarantee to care for the student and pay a monthly allowance of approximately AUD$130. After selection of a student, the District Committee will make every endeavour to place students with Rotary Clubs abroad. Liaison with the hosting Clubs will be maintained throughout the exchange year to ensure the smooth functioning of the exchange. F. Obligations of the Students: Students are to obey the laws of the host country at all times and to accept the discipline of the host school and host parents. The student is an ambassador for Australia and must at all times behave in a manner which will reflect credit on his/her family, community and country. Students are to adapt to the home environment of the host families. The exchange is for a period not exceeding 12 months and students must return directly to Australia on pre-arranged flights at the end of the exchange year. The exchange period is from January to January each year. Students are required to give an undertaking that they will not, in any circumstances, drive a motorised vehicle or vessel whilst under the supervision of the Rotary Youth Exchange Program. Students will not be permitted to go steady with a boy or girl friend. Dating, preferably in company, will be tolerated but for obvious reasons romantic involvement is strongly discouraged. Students must not possess, use, cultivate or manufacture any illegal drugs or restricted or prohibited substances. Students are expected to conform to the laws of the hosting country relating to the drinking of alcohol, but even where alcohol consumption is legally permissible, to avoid its consumption in public places. Exchange students who breach any of these rules may be asked to return home early. G. Obligations of the Parents: Parents should be aware of the cost of the exchange. Costs can be estimated in the range of an equalised contribution fee of approximately $8500 per student. This amount allows for airfares, visas, insurance, briefing costs etc. but not optional tours. This excludes the spending habits of the student in the host country. In examining this aspect of the exchange the usual cost of keeping the student in the family home for the year should be taken into consideration. Due to the increased price in aviation fuel, there may be an additional fuel surcharge charged by the airlines in December (approx. $500).

8 Some countries require students to attend compulsory languages courses on arrival in the host country. The cost of such courses are included in the equalised contribution fee. The Australian Rotary Youth Exchange Program requires all students to be covered under the Australian Rotary Insurance Policy for a twelve month period. This amount is included in the equalised contribution fee. Parents will provide clothing for the student whilst abroad and will also provide an Emergency Fund of AUD$500. The student is a signatory to this account but the fund can only be drawn on with the consent of the student s Rotary Club Counsellor or Club President. This emergency fund must be kept topped up by the parents if used during the exchange year. Any unused amount in the Emergency Fund will be returned to the student prior to leaving the host country. There is a requirement expectation that if the applicant is successful, the applicant s family will arrange hosting of an inbound student for a period of 16 weeks during the applicants year away. It is also a requirement that the family will host in the following years on two other occasions for a total 32 weeks. Overall the family commits to a time of hosting that equates to the time their child is hosted overseas and this can be spread over several years. Applicants are also encouraged to source other host families and inform the sponsoring local Rotary Club of their details. All host families are to be approved by the hosting Rotary Club. Offers to host an inbound student at a future time are also encouraged. H. Lotte Thorkilgaard Trust: Rotary District 9670 may provide limited assistance to eligible students through the Lotte Thorkilgaard Trust. This assistance is usually limited to the return air fare or a portion of this cost. Application forms may be obtained from The District Chairman of D9670. Contact details are listed below. The identity of applicants is not revealed and all applicants are processed with due respect to confidentiality. Applications are Means Tested and the number of Lotte Thorkilgaard Awards granted in any one year, is limited. No relative (son/daughter, stepson/stepdaughter, grandchild, brother, sister) of a Rotarian is eligible to receive financial assistance from the Trust. For further information please contact: The Chairman Rotary District 9670 YEP Rylstone NSW 2849 mobile: yezfidar@outlook.com website:

9 Rotary District 9670 Australia Youth Exchange Program Long Term Exchange Section C: Secondary School Personal Reference READ these instructions carefully before proceeding: A copy of the Confidential School Report is attached to the Initial Application Form. Please complete the applicant details and have the parental release signed by your parents. These are the only entries that you need to complete on this page. Take this form and a stamped addressed envelope to your School Principal/Year Advisor and ask that the remainder of the form be completed by teachers at your school. The return envelope should be addressed to: The Chairman District 9670 Rotary Youth Exchange Program Rylstone NSW 2849 When the form has been completed at your school, the form is to be sent to the address above and NOT to you as the applicant. Only one copy is required. This form is to be mailed to reach The Chairman no later than 1 st April. For further information please contact The Chairman District 9670 Rotary Youth Exchange Program Rylstone NSW yezfidar@outlook.com website: