<p> HOST FAMILY ORIENTATION</p><p>Student Name______Country______</p><p>I ______, representing the Rotary Club of (club president/counselor/district committee member/YEO) ______, in District ______certify that the Family ______(Host Family name) has attended A Host Family Orientation on ______20___. (date given)</p><p>I further Certify that the Host Family was handed a Host Family Handbook, and that the following topics were discussed with the Host Family: - Role of Host Family - Rotary Health Insurance & mandatory - Role of Host Rotary Club Liability insurance - Role of Host Club Counselor - School requirements - Role of District Committee Contact - Rules of the Exchange - Student participation in Host Family - First Night Questions Activities - Student Protection Policy -Student participation in Rotary Club - What to do when there is a problem Activities - Travel Policy - Student participation in Rotary District - RYE website Activities - Adjusting to a new culture -Financial obligations of Host Family, - Host Family Tracking Form Rotary Club and Rotary District - Inbound Student Tracking Form - DOS Welcome Letter ------Your communication with student’s family - Communication with student before arrival - Students should be active with family - Chores -- family member --not guest - Paying for recreational activities and toiletries - NO Alcohol or Smoking - Travel-visiting relative-especially out of state!! - Curfews - Talk to people yourself - Phone & Internet use -- should not be - Get addresses and phone numbers excessive - Notify Youth Exchange Officers of all - Long Distance phone rates -- paying for plans phone calls - ANY travel outside of state notify - Rotary Weekend Attendance/Events District Chair - Boy friends/Girl friends - Communicate with YE officers and - Problems? Need advice? next Host Parents Use Contact Info Sheet - Tax deduction / $50 month plus mileage & - Grades -- They DO count!! parking for non-profit organization - Passport, DS-2019, I-94, airline ticket security - Power of Attorney(18yrs med records/banking)</p><p>Jan 2011 Page 1 of 2 HF217 - Host Family Orientation – HFAudit 8 ** I/we have received a copy of the ESSEX Student Protection Policy which was</p><p> explained to us.</p><p>** I/we have received a copy of the State Department “The Exchange Visitor Program” brochure</p><p>** I/we have received a copy of 22 CFR Part 62 information</p><p>** I/we have participated in this Host Family Orientation.</p><p>** ______This is a temporary placement - first week(s) only ______This is a regular placement </p><p>Print Name:______Signature:______Date:______Print Name:______Signature:______Date:______Print Name:______Signature:______Date:______Print Name:______Signature:______Date:______Print Name:______Signature:______Date:______Print Name:______Signature:______Date:______</p><p>Signed: ______(Club President or Counselor or District Committee Member or YEO) (Date)</p><p>Instructions: Should be retained in the student file.</p><p>Jan 2011 Page 2 of 2 HF217 - Host Family Orientation – HFAudit 8</p>