Monthly Host Family Report

Monthly Host Family Report
Report for the month of (报告月份)*
School Name (学校名称)*
Student ID Name (学生姓名)*
Host Family Name (住家姓名)*
Today's Date (填表日期):*

MonthDayYear
Monthly Evaluation 1 = Poor, 2 = Fair, 3 = Good, 4 = Excellent (月度评价 1=很差，2=一般，3=良好，4=优秀)

Student understands and follows rules (学生能够理解并遵守规定)*

	1	2	3	4

1 is Poor, 4 is Excellent

Student's Participation in School/Community Activities (学生能够参与学校/社区活动)*

	1	2	3	4

1 is Poor, 4 is Excellent

Student's academic performance (学生的学业情况)*

	1	2	3	4

1 is Poor, 4 is Excellent

Student's overall conversational language abilities (学生整体口语能力)*

	1	2	3	4

1 is Poor, 4 is Excellent

Student's level of comfort and ease with Host Family (学生与住家相处感觉舒适而自在)*

	1	2	3	4

1 is Poor, 4 is Excellent

Student's interaction with the Host Family (学生与住家的交流)*

	1	2	3	4

1 is Poor, 4 is Excellent

Host family's interest/participation in student's personal welfare (住家关心/帮助学生的个人需求)*

	1	2	3	4

1 is Poor, 4 is Excellent

Host family's interest/participation in student's education (住家关心/帮助学生的学业)*

	1	2	3	4

1 is Poor, 4 is Excellent

Host family's interest/participation in student's extracurricular activities (住家关心/帮助学生参加课外活动)*

	1	2	3	4

1 is Poor, 4 is Excellent

Overall relationship between host family and student (住家与学生的关系)*

	1	2	3	4

1 is Poor, 4 is Excellent

Please provide any additional comments, particularly for ratings of 1 or 2 in any category (请给出额外说明，特别是对只给了1分或2分的项目进行说明).*
Feedback and Comments (反馈与说明)
Describe any academic challenges or improvements exhibited or expressed by the student (请描述下学生提到的自己在学业方面有何种挑战或进展).*
Give examples of the student's eating habits and/or mealtime interactions (请举例说明与学生在饮食习惯和就餐时的交流）*
How does the student spend his/her recreational time (学生个人娱乐时间都做些什么)?*
Describe any other concerns or observations you have about your relationship with the student (if any) (请说明您在与学生的关系方面有哪些担忧或发现（如果有的话）).*
Were there any important events that took place in the student's life this month (学生近期有什么重大活动)?*
Did the student miss any days of school this month? If so, how many days were they absent and what was the reason? (学生本月是否有缺课，如有，缺课多少天？学生为什么缺课？)*
How will you celebrate any upcoming holidays or events this month (ex. Halloween, Thanksgiving, New Year's, etc.) (您将如何庆祝本月即将到来的节日（如万圣节、感恩节、新年等）)?*
Have you noticed anything significant, either academically or behaviorally, that you would like the student's natural parents to be aware of since last month's report (if applicable) (自上个月的报告起，学生在学业或行为方面有没有您觉得需要让学生父母了解的事情)?*
Please provide any feedback from teachers. (学校教师对孩子的综合反馈)*
Daily study time after school: (学生每天在家学习的时间)*

Less than 1 hour (1小时以下)1-2 hours (1-2小时)2- 3 hours (2-3小时)More than 3 hours (3小时以上)
Has the student been tardy to school this month? (学生本周期内是否缺课?)*

No 从未Occasionally 偶尔Often 经常
How many times and what's the reason? （请标明次数及原因）*
What does the student mainly do in his/her spare time? (choose 3 items) 学生日常娱乐的时间主要花在（选择三项）*

Sport activities 体育运动Meet with friends 朋友聚会Video games 电子游戏Reading 阅读Personal hobbies 个人兴趣爱好Other 其他Other
What time does the student usually go to sleep? (学生每晚大概几点休息?)*

Before 10PM (22：00以前)Between 10PM and midnightAfter midnight (24：00以后)
Why did the student get to sleep so late? (晚睡的原因？)*
Did the student invite any friends to join in host family gatherings, or did he/she go to any of his/her friends’ parties? (学生本月是否邀请TA的朋友来家庭聚会或参与其他朋友的聚会？) (Please attach photos below) （请附照片）*

None (从未)1-2 times (1-2次)More than 2 times (2次以上)
Did the student have any illness or health concerns this month? (学生本月是否有生病或者由其他需要注意的健康问题？)*

No (没有)Yes (有)Other
If yes, please specify. (请详细描述）
Did the student join any club(s)? (学生是否加入了学校的任何学生社团，表现如何？) If yes, please attach photos ？（请附带照片）*

No (没有)Yes (有)
If yes, how does the student like the club(s)? (如果有，学生有多喜欢这个社团？)
Did the student participate in any volunteer work? (学生是否加入了任何义工类活动?) If yes, please attach photos. （请附带照片）*

No (没有)Yes (有)
If yes, how is he/she doing? (如果有,学生感觉如何?)
Please provide several pictures of the student so that we may share them with his/her parents (请提供一些学生的生活照，以便我们分享给学生家长)..
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Monthly Host Family Report

Monthly Evaluation 1 = Poor, 2 = Fair, 3 = Good, 4 = Excellent (月度评价 1=很差，2=一般，3=良好，4=优秀)

Feedback and Comments (反馈与说明)

Please provide several pictures of the student so that we may share them with his/her parents (请提供一些学生的生活照，以便我们分享给学生家长)..