E-mail Address: *

Name *

Student Name *

Exchange Program Coordinator Name *

Code from email *

How did you learn about the opportunity to become an ERDT/SHARE! Host Family?

Church/Religious Group
Radio
Friend
Internet Search/Ad
Flyer
Other

Was a choice of student applications made available to your family in order to select your exchange student?

Yes
No
Not sure

Did your Exchange Program Coordinator personally visit you in your home BEFORE your student arrived?

Yes
No

Did you receive an ERDT/SHARE! Host Family Packet containing your students application, the ERDT/SHARE Host Family Handbook, a Culturgram of your students country, etc?

Yes
No
Not sure

Do you feel that your Exchange Program Coordinator adequately described the exchange experience, including the responsibilities and costs to your family?

Yes
No
Not sure

If NO, please explain what information you feel you lacked prior to beginning your host experience.

At what point did your Exchange Program Coordinator provide your family with an orientation?

Before our student arrived
After our student arrived
Both before and after our student arrived
Not sure

How would you rate the preparation your family received from ERDT/SHARE! and your local coordinator prior to your students arrival?

Excellent
Good
Fair
Poor

Since your student arrived in your family, how often have you had contact with your EPC?

two or more times a month
about once a month
less than once a month
never

Do you feel that your Exchange Program Coordinator has been helpful and available so far?

Yes
No
Not sure

If no, please explain.

The Department of State requires an additional visit by a person other than your Exchange Program Coordinator. Did this visit take place?

Yes
No
Don't know

Has your student required medical treatment since his/her arrival?

Yes
No
Not Sure

If YES, have you filed an insurance claim?

Yes
No

How would you describe the relationship between you (the host parents) and your exchange student?

Excellent
Good
Fair
Poor

How would you describe the relationship between your children (if applicable) and your exchange student?

Excellent
Good
Fair
Poor

Taking your experience to date into consideration, would you recommend the ERDT/SHARE! High School Exchange Program to another host family in your community?

Yes
No
Not sure

Why did you decide to become a host family?

What has been one of the most positive aspects of being a host family?

Would you like a follow-up call to discuss any issues or concerns that this evaluation raises?

Yes
No

Do you have any suggestions for the future of our program?

Please provide any additional comments:

* Required

Host Family Initial Program Evaluation

310-450-4624