DOS, ESSEX & District Forms
Youth Exchange Forms
The following Forms need to be completed and returned to the District Office for each Inbound student:
- Guarantee Form – MUST BE TYPED!!!
- IB21 – Inbound Electronic Hosting Form (MUST BE TYPED!)
- IB25 – School Admission Letter
- IB29 - School Checklist
- IB37 – Resource List
- R-1 Club Compliance Certification
Host Family Certification and Process
- Identify the Host Family and then conduct an In-Home interview with all members of the Host Family. *Once the family has completed their application process you can then go into the Host Family records and complete the Interview Box located on the ESSEX YEO Portal/Host Family.
- Host Family must complete the Host Family Application via the ESSEX Host Family Portal
- Host Families will be asked to supply 2 references while completing the Host Family Application. A link to complete the reference will be sent automatically to these people identified in the Host Family Application
- Host families will receive an email to complete background checks. Anyone living in the home over the age of 18 MUST complete a CBC.
- Host Family Orientation - Each family must attend a Host Family orientation prior to the students placement. Attendance at a Host Family Orientation must be documented in the YEO Portal. Click here for instructions.
- Host Families cannot view the students application until they have been vetted and approved. (DOS regulation)
- Host Families cannot receive compensation for hosting a student. (DOS regulation)
- Inbound student cannot live with a relative (DOS regulation)
Volunteer Certification and Process
- Complete and submit the Volunteer Application/Affidavit via the ESSEX Volunteer Portal
- The people identified as References will be sent a link to automatically complete a reference
- All volunteers will receive an email to complete a background check. This is an annual requirement.
- Access to the Dept of State Online testing will be sent automatically - annual requirement
NOTE: YEO's cannot view the students application until they have been vetted and approved. (DOS regulation)
Reference for Youth Exchange Officers:
D7390 Specific Forms
The forms listed in this section are specific to District 7390 and are not part of the required forms for the Department of State audit.
- Comittment to Host an Inbound Student
- Inbound Student Code of Conduct
- Outbound Student Code of Conduct
- Sample DS-2019
- Inbound Return Flight Form
- D7390 Permission to Travel Form
- Host Family Interview Form
- Guidelines for Chaperones
- Student Protection Policy Allegation Reporting Guidelines
- Calendar of Events
- Student Protection Policy
- Host Family Recruitment
- Host Family Recruitment Brochure
- ESSEX Brochure
- YE Handout from 2016 District Assembly
- Club Request for Reimbursement after hosting an Overnight Event
- The R-1 Club Compliance Certification will be emailed by the District Office to the D7390 hosting and/or sponsoring Rotary Club after the student has been approved for exchange by both District 7390 Rotary Club and District Youth Exchange Committee Officer. A club only needs to complete the Club Compliance Certification once for every year in which they host and/or sponsor a youth exchange student.
- 2016-17 RI Youth Exchange Renewal Form