Rotary District 7150 Youth Exchange, Inc.
Post Youth Exchange Program Evaluation
SCHOOL
(We are asking your help to continue to improve our program. Please answer these questions as honestly and with as much detail as possible - Write on back of page or attach additional pages if you need more space)
Exchange Student’s Name Country Dates of Exchange
School Attended Name of Guidance Counselor Telephone No.
Sponsoring Rotary Club Rotary Club Contact Telephone no.
1 2 3 4 5 N/A
Poor Somewhat Satisfied Very Excellent Not Applicable
Dissatisfied Satisfied
Using the above rating scale, please indicate your assessment of the following five questions:
1. Was the Rotary Exchange Student an asset to the school?
2. Was the Rotary Exchange Student accepted by the rest of the student body?
3. Was the student’s attendance and grades satisfactory?
4.______Was this student’s English proficiency sufficient for meaningful class participation?
5. Please rate your contact with and support from- (Please explain reasons for a rating below on reverse)
.
Host Family Host Club Counselor Other - Please specify
6. Were you aware of our Academic, Athletic, Extracurricular Policy? Yes, No
6a. Did he/she participate in Athletics, Extracurricular Activities?
If so, what?
6b.Would you change the courses the student took? ___Yes, ___No
If so, what would you substitute?
7. Please tell us about problems you experienced, if any, and any changes you would recommend to make the program better for future exchange students attending your school.
8. Was the student an administrative burden to the school? Yes, No
9. Would you accept another Rotary Exchange Student? Yes, No
10. Would you help us recruit students from your school to be future Exchange Students? Yes, No
11. Could we put a program on in your school for language students ___Yes, No; if Yes, do you prefer ____ spring, ____fall
Please mail your response to: Randy Wilson, 9150 Butler Rd, Sauquoit, NY 13456