Outbound Student Monthly Report

The following form must be completed by outbound students on a monthly basis. The form is due by the 1st of every month. Your responses below will be sent directly to the RYE District 6270 Outbound Coordinator. If you mark it as confidential, it will be held in the strictest of confidences.

Student Info
Your First and Last Name
Your Email
Host Parent Info
Name
Address (please type in complete address in one line, separated by commas)
Phone (Include Country Code)
Email
Club President Info
Name
Email
Phone
Host Club Counselor
Name
Email
Phone
Details
Is this CONFIDENTIAL?	Yes No
Describe any problems or difficulties.
What was done to resolve problem?
Do you want us to help?	Yes No
What is your life overseas like?
Tell us about your RYEC Conferences
Language - Please rate
Understanding
Speaking
Rate Your Relationships
Host Family
Host Rotary
Teachers
Students
RYE Counselor
Sponsoring Club
Other
How many Host Rotary Club meetings did you attend this month?
How many times per month are you meeting with your Club Counselor?
Tell us about your involvement with the club
How much monthly allowance are you receiving?
Is your allowance on time?	Yes No