District 6290 - Rotary International Youth Exchange

Promoting Peace and Understanding throughout the World

Rotary Club Statement of Compliance

And Commitment Form for 2015 Inbounds

District 6290 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 any 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.

Each Rotary Club is responsible to review and comply with the Rotary International “Rotary Code of Policies (RCP), Sections 2.110 and 41.080 (February 2006), the U.S. Department of State J1 Visa Regulations 2010, the District 6290 Youth Protection Policy(amended 12/2010), and the Reporting Guidelines; to implement these policies, regulations and guidelines in your Club Youth Exchange Program, and to complete the following statement of compliance. This statement should be signed by the Club President and the Club Youth Exchange Officer. The Statement of Compliance must be completed and returned to District 6290 Chair, Lody Zwarensteyn, by June 30, 2014, to participate in the 2015-2016 Central States Youth Exchange Program. Lody’s contact information is: 3633 Cook Valley Blvd. S.E., Grand Rapids, MI 49546. Phone -- 616-581-2261, E-mail –

The District 6290 Rotary Youth Exchange Program hereby below shall be referred to as the “District RYEP”.

The Central States Rotary Youth Exchange Program, Inc. hereby below shall be referred to as “CSRYE”.

The Rotary Club of ______hereby below shall be referred to as “The Rotary Club”.

Statement of Compliance

The Rotary Club hereby attests that it’s Youth Exchange Officer and Board have reviewed the Rotary International “Rotary Code of Policies (RCP), Sections 2.110 and 41.080 (February 2006), the U.S. Department of State J1 Visa Regulations 2010, the District 6290 Youth Protection Policy, and the District 6290 Reporting Guidelines (2010 updates). In addition we attest that our Board of Directors and Club Youth Exchange Officer commit to comply with these Policies, Regulations, and these Reporting Guidelines at all times, for the protection of each exchange student.

Because the Rotary Youth Exchange Program operates within the Confines of District 6290 RYEP and Central States Rotary Youth Exchange Program, Inc. multi-District Program., the Rotary Club agrees that it will participate in youth exchange under the Direction of the District RYEP Committee and CSRYE (for long-term exchanges) only, and is prohibited from arranging exchanges outside of the District structure.

The Rotary Club will comply with U.S. Department of State requirements to participate in specified training and testing. The Rotary Club’s Youth Exchange Officer agrees to obtain annual Certification as a Local Coordinator by the US Department of State. (Does not apply to Canadian Clubs.)

Volunteers

The Rotary Club hereby agrees to use the District 6290 Volunteer Affidavit (VA) to register each Club volunteer and community volunteer who will have repeated contact with Youth Exchange Students hosted by The Rotary Club, and to submit these to the District RYEP with Inbound student Guarantee Form, or upon request, as required. In addition, we agree to provide a current criminal background check (CBC) for each Volunteer Affidavit (VA) submitted. Repeated contact means direct unsupervised contact with one or more Youth Exchange students. The VA and CBC for the Rotary Club Youth Exchange Officer (YEO) and Youth Exchange Counselor (YEC) will be submitted to the District RYEP with each Inbound Student’s returned Guarantee Form. The Rotary Club agrees to update each VA and CBC every year, and to promptly provide VA and CBC for new volunteers. The Rotary Club agrees to interview volunteers to determine suitability to work with youth. The Rotary Club agrees that the Youth Exchange Officer (YEO), and/or Youth Exchange Counselor (YEC) must attend at least one (1) scheduled District RYEP YEO Training session each year. The Rotary Club is not limited to the YEO and YEC and may send Club President and/or Club Officers and/or Club Directors and/or members of the YE committee to District RYEP YEO Training. The Rotary Club agrees that neither the YEO nor the YEC may be a host parent for any exchange student. The Rotary Club agrees that it will have at least one YEC for Inbound student(s) and Outbound student(s).

Any adult involved in a Rotary youth program against whom an allegation of sexual abuse or harassment is made must be removed from all contact with youth involved in the program until the matter is resolved. Any Rotarian who admits to, is convicted of, or is otherwise found to have engaged in sexual abuse or harassment will be terminated from Rotary Club membership. Any non-Rotarian who admits to, is convicted of, or is otherwise found to have engaged in sexual abuse or harassment must be prohibited from working with youth in a Rotary context. Immediately report all cases of sexual abuse or harassment to the appropriate law enforcement agency.

The Volunteer Affidavit Forms and Criminal Background Checks will be kept on file in perpetuity, and copies will be available for audit by the District 6290 Compliance Committee. They may be kept for long-term storage by the District.

Host Families

The Rotary Club hereby agrees to use the current CSRYE Host Home Application form (HHA) and to screen each family which applies to host a Rotary Youth Exchange Student. Host Families that have applied, had references checked, and been interviewed have by the application agreed to provide, or allow The Rotary Club to acquire criminal background checks, for every adult living in the host home (or would be living in the host home anytime during the Rotary Youth Exchange Student’s stay) that are 18 years of age or older. The Rotary Club commits to providing the District RYEP with the HHA and CBC for the Inbound Student’s first host family with the Guarantee Form and subsequent host families a minimum of two (2) weeks prior to the student changing host families. Furthermore The Rotary Club will be required to provide a CSRYE Host Home Profile, conduct a Host Family Orientation, review the host family’s general liability and auto insurance coverage, and complete a checklist for the Orientation. The Host Home Profile including pictures and the Host Family Orientation checklist must be submitted to District RYEP with the HHA and CBC’s.

The Rotary Club agrees that exchange students under its care WILL NOT be placed with a host family until all of the following have been completed:

  • Host Home Application completed, and references checked
  • In home interview conducted by The Rotary Club YEO or his/her designate of all members of the host family
  • Criminal background check done for each member of the Host Family that is (or will be during student’s stay) 18 years of age or older.
  • Orientation conducted for Host Family or Families including providing family with a copy of the RYEP rules and requirements, abuse and harassment awareness and prevention; and a checklist filled out
  • Host Home Profile (HHP) including required photographs
  • HHA, CBC, orientation checklist and HHP submitted to the District RYEP together with YEO’s and YEC’s VA and CBC.

The Rotary Club agrees that after the exchange student is residing with the host family it will:

  • Conduct announced and unannounced home visits
  • Will have more than one (1) host family but not more than three (3) host families
  • YEC will converse with host family at least once a month and keep a written record which will include date, place and what was discussed, using the standard CSRYE Visitation Log. The YEC is cautioned not to record confidential discussions but to generalize the meeting.

The Host Home Application Forms and Criminal Background Checks will be kept on file in perpetuity, and copies will be available for audit by the District 6290 Compliance Committee. These may be stored long-term by the District.

Inbound Students

The Rotary Club agrees to provide the Inbound Student with the following information before or upon arrival to host country:

  • Name and contact information for host Club Counselor (YEC)
  • Name and contact information for host Club President
  • Name and contact information for two (2) non-Rotarian resource persons, one male and one female
  • Local medical, dental, and mental health care professionals
  • Local law enforcement agencies
  • Local social service resources, including suicide prevention hotlines, rape crisis hotlines, and local child protection agencies

The Rotary Club agrees that after the exchange student is residing with the host family it will assure the following:

  • YEC will meet with Inbound exchange student at least once a month and keep a written record which will include date, place and what was discussed, using the standard CSRYE Visitation Log. (The YEC is cautioned not to record confidential discussions but to generalize the meeting.)
  • Monitor Exchange Student for compliance with program rules, including instructing, correcting and advising student of cause and effect.

Further the Rotary Club agrees to inform the District RYEP Inbound Coordinator and/or Chair of any non-compliance with program rules by student, and where agreed between The Rotary Club and District RYEP, terminate the student’s exchange and return them home at the earliest practical time by a route agreed upon by The Rotary Club, the District RYEP, the sponsor Rotary Club, the sponsor District, and the exchangee’s parents or legal guardians. Under no circumstance shall The Rotary Club terminate and return the student on their own initiative.

Selection of Outbound Candidates

The Rotary Club agrees to follow the District RYEP and CSRYE guidelines and eligibility for selection of Outbound Candidates. The Rotary Club further agrees that it is not eligible to select Outbound Candidates (for departure the following summer) if it has not committed to host Inbound student(s) in the same year as the departing Outbound. Such commitment shall be in the form of the District RYEP Club Commitment Form. The Rotary Club understands that parents of Outbound Students are not required to host incoming students.

Failure to submit the District 6290 Club Compliance Statement prior to July 1 of each year, or failure to implement and comply with each step detailed above may result in suspension of the Club from participation in Rotary Youth Exchange until such time as compliance can be restored.

Rotary Club President / Club Youth Exchange Officer
Signature / Signature
Printed Name / Printed Name
Date / Date

COMMITMENT FORM FOR 2015 INBOUNDS

The Rotary District 6290 Long Term Youth Exchange Program needs your commitments for hosting inbound exchange students during the 2015 calendar year. This obligates your Club to host the number of inbound students you select for the 11 or 12 month duration of their stay, and entitles you to send up to one outbound candidate for each inbound commitment to the 2014District November interview conference without designating alternates.

The Rotary Club of ______makes its commitment to host the number of inbound exchange students listed below as Total Inbound Commitment and who will arrive during the calendar year2015(January or August 2015). The same Rotary Club RYEO (Rotary Youth Exchange Officer or Committee Chair) also agrees to attend at least onetraining session planned for the September and/or April District Youth Exchange Conferences and to assure that all required representatives of the Club’s Youth Exchange Program comply with Rotary and US State Department training and testing regulations for exchange programs. (State Department Regulations not applicable for Canadian Clubs.)

Country preferences will be considered and fulfilled if possible, but no guarantees are made. Rotary Clubs will be assessed $700.00 US a year for each inbound after assignment to cover Central States Program and District Conferences Fees. (Inbound students’ families will be assessed CSRYE insurance fees.) The Rotary Club will be responsible for a $75.00 US per month (minimum) allowance for each Inbound Student for the duration of their stay. We will also be billed our portion of the bus cost for the winter Canadian conference. (With $100 budget for student holiday and birthday gifts, the minimum expected Club budget per inbound student is about $1800, not including meals at Club meetings, etc.)

INBOUND PREFERENCES / January or August / Gender Preference / Country/Continent
(circle one) / (circle)
First Inbound student / Jan / Aug / Female / Male
Second Inbound student / Jan / Aug / Female / Male
Third Inbound student / Jan / Aug / Female / Male

Total Inbound Commitment:______students.

CLUB COMMITMENT GUARANTEE

The Board of Directors of the above named Rotary Club fully endorses and agrees to host the number of inbound exchange students listed in the Total Inbound Commitment above, and the RYEO and/or Counselor commits to attend the District RYE Program training sessions and to assure minimum required training of all other volunteers. The Rotary Club agrees to comply with Rotary International regulations for Youth Exchange, and to abide by and sign the Club Compliance form. If our Club is unable to fulfill this obligation, we will assist in finding another Rotary Club to host our students and will remain responsible for the financial obligations even if we do not host.

Signature
Club President / Club Youth Exchange Officer / Club YE Counselor
Print Name
Address
City/State/Zip
Home Phone
Office Phone
Cell Phone
Fax:
E-Mail

This form it to be returnedtoLody Zwarensteyn, District Chairman YE

Scanned email attachments preferred.3633 Cook Valley Blvd. S.E.

rand Rapids, MI 49546

616-581-2261

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