Short Term‎ > ‎

Short Term Application

Before You Begin


Please contact your local Rotary club BEFORE completing the application.  Some clubs have additional application forms and/or rules. If you live in the Rotary ESSEX area and need help locating a club in your area, you may call our toll free number 1-888-ROTARY-X (1-888-768-2799).


SHORT TERM APPLICATION


Note: The link "Short Term Application" is a writable .pdf. This file can be downloaded to your desktop, completed, saved, and printed using the free version of Adobe Acrobat Reader. If you do not already have Adobe Acrobat, download it FREE here.


IMPORTANT INFORMATION

 

Short term families must register through the ESSEX Portal. The cost of the application process fee is $125. All background checks will now be covered by ESSEX. The link to use for the Host Family application is: https://yehub.net/ESX-hfapp

Two references will be needed including their email addresses. References cannot be related or be a Rotarian.

 

Instructions

 

Type in the requested information, including the name, address and phone number of your local Rotary Club chairman and your district chairman. E-mail addresses are greatly appreciated. ALL applications must be typed. Scanning pictures onto the first and last pages works well.

The application does not print out well on some ink jet printers. We recommend that you fill out and print the application on a laser printer, if possible.

Print 4 copies. All copies must have original signatures and identical scanned color photos . All signatures must be in blue ink. Submit one ESSEX Short-Term Exchange Check List to your Rotary Club Youth Exchange Officer (YEO). The only part of this check list you need to complete is your last name and first name with a minimum of 3 country choices with #1 being your first choiceof countries. The Rotary Club YEO and District Chair for Short-Term will complete the rest of the check list.


You have already completed your country choices on the check list, but it is very, very important that you communicate to your club chairman and/or your district chairman how flexible you are. For example, if you are willing to go to any Spanish–speaking
country, make sure your chairman advises us on your application checklist. If you will only go to your first choice or if there is somewhere you won’t go, let us know. Sometimes we are unable to get cooperation from the foreign contacts. When this happens having several options helps find you a suitable match.

Keep one copy of the application for your files. Mail or deliver your other 3 to the local Rotary club. The local Rotary club will interview you before referring your application to the district. If you are accepted for the program, the Rotary District Short-Term Chair
or Youth Exchange Chair will sign your application before it is sent onto ESSEX STEP Chair.


To Apply for Medical Insurance

All students are required to carry the CISI-Bolduc medical insurance Policy Plan B with personal Liability Coverage. To download the application to complete and submit with your application package, please click on the "2016 CISI Insurance Application" link above,and then click on " Short Term Application Download and associated forms".  A check payable to CISI-Bolduc must be sent along with the insurance application as part of the Application Package as follows:

For a 3-4 week each way exchange the 1 month policy B must be taken for the cost of $76.00

For a 6 week exchange the 3 month policy must be taken for the cost of $208.00. This type of policy is required when a short term exchange is requested and completed with a Country from the Southern Hemisphere. By ESSEX rule our leg of the exchange can not be longer than 6 weeks. By requirement of the foreign Country there leg of the exchange must take place during Dec-Jan-Feb and be a minimum of 8 weeks which means you must get permission from your local high school officials to allow the foreign student to attend the school as an observer only at the time your son/daughter is in school during the exchange period of time.


Associated Fees

The following checks must be submitted with your application:

  
• One payable to “ESSEX STEP” in the amount of $125.00, application fee
• One payable to CISI-Bolduc in the amount as indicated in the above Paragraph
• One payable to your Rotary Club and/or district if there are processing fees.  

  Please check with your sponsoring District/Rotary Club for associated fees.



Apply for Your Passport

Apply for your passport if you don’t already have one. Be sure to allow enough time for it to be processed.

A cost is involved for a passport

 

For short-term exchanges, the student's family can make their own travel arrangements or use the ESSEX recommended travel agency:


Tzell Park Avenue
A Branch of Tzell Travel
456 West Main Street Suite 2
Norwich, CT 06360
Telephone: (800) 888-5275 
Fax: (860) 886-1853
theresa@tzellyouthexchange.com
EMERGENCY ONLY for Theresa:  860-326-6396