2023-2024 Youth Exchange Pre-Application Form

2023-2024 High School Year

Rotary YES/SCANEX is a multi-district of Rotary International including District 5330. Information is available at www.Rotary.org

A ROTARY ACADEMIC YEAR HIGH SCHOOL (LONG TERM) EXCHANGE STUDENT travels abroad and attends school in the host country for a full year. They also have opportunities to participate in camps, meetings, and trips in their host country. They will be immersed in the language & culture of their host country. The student ambassador will be hosted by a local Rotary Club in the exchange country and will be hosted by one to four families approved by Rotary. The host Rotary Club will issue a monthly stipend in the foreign currency equivalent to $75-$100. This is an enriching experience for the student & an opportunity to develop lifelong friendships. Universities recognize the value of greater self-reliance & social maturity the students acquire during their year abroad.

Exchange Countries Currenly Available

Asia – Taiwan, Thailand, Japan
Europe – Austria, Belgium, Czech Republic, Denmark, Finland, France, Germany, Hungary, Italy, Poland, Spain, Sweden & Switzerland
South/Central America – Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, Paraguay & Peru
New Zealand

Rotary YES/SCANEX reserves the right to add or delete from the list.

WHO CAN PARTICIPATE? The youth exchange program is open to qualified young men and women between the ages of 15 and 18. The sons and daughters of Non-Rotarians and Rotarians are eligible. Ideally the student should be either a high school sophomore, junior or senior. Gap year students may be accepted. Students must be above average academically. Parent(s) and applicants will be interviewed by a local Rotary Club and if accepted the club will endorse the application.

The Program covers room, board, tuition and a monthly stipend. The student/Family pays for the airfare, insurance, two orientations, visa & other materials. The flat fee for those items is currently $5,250.

After completing this form click submit to email this form to Cynthia Mansell.

If you have any additional questions you can use the contact link at the bottom of the page to email Cynthia directly.

Student Name *

First

Last

Male or Female *

Female
Male

Home Address *

Address Line 1

Address Line 2

City

State

Zip Code

Best Phone Number to Reach You *

Is this a Cell Phone? *

Email *

What is your Birthday *

Gender *

Male
Female

Date of Birth *

High School Name *

High School Address *

Address Line 1

Address Line 2

City

State

Zip Code

What Grade are you in Now *

Have you talked to a Rotary Club? *

If so which one? *

Please indicate 3 countries of your choice *

Example like this 1. Germany 2. France 3. Canada

Parent/Guardian Names: *

First

Last

Todays Date *