Area Representative Evaluation Report
FEBRUARY
Name of Area Representative Completing This Form:
*
First Name
Last Name
Student's Name:
*
Please Select
Catarina Menossi
Gabriel Aupetit
Giulia Bartolozzi
Heitor Pusch
Inigo Elorriaga
Isaac Abreu
Isaac Braga
Isabella Hervella
Martina Baudo
Mauro Sanchez
Samuel Quirino
Sara Munoz
Vinicius Fernandes
Student's Gender:
*
Female
Male
Student's Home Country
*
Please Select
Brazil
China
France
Germany
Italy
Slovakia
Spain
Program Season:
*
Please Select
2025/2026 School Year
2026 semester
2026/2027 School Year
Student's Name:
*
First Name
Last Name
Host Family's Name:
*
Host Family's Location:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Based on the communications you have had with the student during the month of February, please rate the student's experience:
*
Rows
Positive
Fair
Negative
Needs Improvement
Host Family Interaction
Host Family's Support Towards the Student
Overall Relationship Between the Student and the Host Family
Student's Adaptation to American Culture
Student's Experience at School
Student's Interaction with American Friends
Please select the dates that you communicated with the STUDENT during the month of February:
*
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
Please select the ways in which you communicated with the STUDENT in the month of February:
*
E-mail
Phone Call
Text Message
Facebook Messaging
In Person Visit
WhatsApp Communication
Instagram Messaging
Zoom
Skype
Other
Please use the following scale to rate the host family's experience based on your communication with them, as well as your personal observations. The following categories focus on how the host family feels about the student and experience to date.
*
Rows
Excellent
Good
Fair
Needs improvement
Student's Care and Love Towards the Host Family.
Overall Relationship between the Student and Host Family
Student's Interest in Being Involved with the Host Family and Their Activities
Host Family's Communication with the Student
Student's Behavior at Home
Student's Academic Performance at School
Student's Behavior at School
Student's English Skills
Please select the dates that you communicated with the HOST FAMILY during the month of February:
*
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
Please select the ways in which you communicated with the HOST FAMILY in February:
*
E-mail
Phone Call
Text Message
Facebook Messaging
In Person Visit
WhatsApp Communication
Instagram Messaging
Zoom
Skype
Other
Please share some of the events or activities that the student has participated in with the host family and/or with friends.
*
How would you describe the student's English language improvement and academic performance at school?
*
Please describe how the student has been adapting to his/her cultural exchange experience in the local community.
*
Please share any additional questions or concerns you may have about this placement:
*
Area Representative's Electronic Signature
*
Today's Date:
*
/
Month
/
Day
Year
Date
Your E-mail Address:
*
example@example.com
Submit
Follow ARISE on social media:
Please leave the following space blank as it is intended for use by ARISE's main office.
Should be Empty: