Youth Exchange Officer Monthly Report

Student's Name (Required)

Hosted By Rotary Club of (Required)

Youth Exchange Officer's Name (Required)

YEO E-Mail (Required)

YEO Contact Phone Number

Date of anticipated move to next host family (MM/DD/YYYY)

Activities since last report

Tell us about your students activities such as presentations given, social events attended, conferences and Rotary meetings, community projects, etc.

How is your student acclimating to:

1. School

2. Their Host Family

3. Your Rotary Club

4. Your Community

Tell us about any problem areas

Do any of these problems require assistance from the District Committee?
Yes No

Tell us about how well your Student can speak English. What have you done to improve it?

In what groups/activities does your student participate in school?

Do you expect a visit form the Biological parents? When?

Do you need help with this?
Yes No

How often does your student attend Rotary meetings?

Have they attended any other Rotary Club meetings? Yes No

Have you checked the website for upcoming events? Yes No

What amount of monthly allowance does your club provide?

Has your student submitted their monthly reports? Yes No

How frequently do you meet with your student?

How frequently do you check with host family?

How frequently does your student meet with their counselor?

Do all your host families have a copy of the manual? Yes No

1st night questions?

Tell us about the things your student has done. Please include any comments, suggestions, requests, or complaints you may wish to share with us.

Name of Person submitting this form? (required)

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