Area Representative Evaluation Report (April)
ARISE (Association Representing International Student Exchange)
Name of the Area Representative who is completing this form:
*
First Name
Last Name
Student's Name:
*
First Name
Last Name
Exchange program season:
*
Fall 2024
Fall 2025
Spring 2025
Student's Home Country
*
Please Select
Brazil
Germany
France
Italy
Spain
Slovakia
Student's Gender:
*
Female
Male
Host Family Location:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Host Family Name:
*
Please use the following scale to rate student's experience:
*
Excellent
Good
Fair
Needs Improvement
Overall relationship between host family & student
Student's adaptation to US culture
Student's experience at school
Student's English skills improvement
Participation in activities
Student's grades
Student's behavior
Student's care toward the host family
Please select the dates that you communicated with the STUDENT during the month of April:
*
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Please select the ways in which you communicated with the STUDENT in the month of April:
*
E-mail
Phone Call
Text Message
Facebook Messaging
In Person Visit
WhatsApp Communication
Instagram Messaging
Zoom
Skype
Other
Please select the dates that you communicated with the HOST FAMILY during the month of April:
*
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Please use the following scale to rate the host family's experience:
*
Excellent
Good
Fair
Needs improvement
Overall relationship between student and host family
Student's interest to be involved with the host family and their activities.
Host family's communication with the student.
Host Family's care towards the student
Host Family interaction with student
Host family overall thoughts on the cultural exchange program
Please select the ways in which you communicated with the HOST FAMILY:
*
E-mail
Phone Call
Text Message
Facebook Messaging
In Person Visit
WhatsApp Communication
Instagram Messaging
Zoom
Skype
Other
Please share any additional questions or concerns about this placement:
*
Area Representative Signature
*
Today's Date:
*
/
Month
/
Day
Year
Date
Area Representative E-mail.
*
example@example.com
Submit
(Please don't complete this section) This space is for ARISE's staff main office for notes.
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