IB Quarterly Report

Date (required)

Your Name (required)

Your Email (required)

Current Host Parents First and Last Names (required)

Host Rotary Club (required)

Rotary Counselor (required)

Rotary Counselor Phone (required)

Are you receiving a Rotary stipend? (required)

YesNo

If Yes, how much is the stipend?

Are you attending Rotary meetings? (required)

YesNo

How often do you attend? (required)

WeeklyMonthlyOftenNever

Have you presented your program yet? (required)

YesNo

If not, do you know when?

Do you have a mobile phone? (required)

YesNo

If so, what is your phone number? (required)

Please use the space below to write a little about how life is going. What new foods have you tried? How is school? What classes are you taking? Are you participating in sports or other activities? Have you gone on any trips with your Host family or other Rotary family? Let us know what is new and exciting for you. The space will expand as much as you need. (required)

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