fsl.ednet.ns.ca web viewinterview questionnaire 2016-2017. structure of the interview. the selection...

NOVA SCOTIA/QUÉBEC SIX-MONTH EXCHANGE PROGRAMSUMMARY OF THE APPLICANT’S APPLICATION

PLEASE COMPLETE THIS SUMMARY ELECTRONICALLY BEFORE SUBMITTING THE APPLICATION TO THE DEPARTMENT OF EDUCATION AND EARLY CHILDHOOD DEVELOPMENT

First Name: Last Name: Date of birth: YY - MM - DD

Sex : F M Grade in September 2016: French Program (specify all that apply): Early Immersion Late Immersion Integrated French Core French

IB Program Presently not registered in any French program Age as of September 2016: years months

School (in September 2016) : School Board:

City: Name of school liaison teacher:

HOST FAMILY

Is a mixed exchange (boy/girl) possible? Yes No Mother or Guardian‘s occupation: Father or Guardian’s occupation:

Number of brothers: Number of sisters: Other people in the household:

House Apartment/Condo Rural Small town Urban

HEALTH Allergies: Yes No Specify:

Special dietary needs:

Other health information:

Yes No Specify:

Yes No

Specify:

SMOKING Student smoker: Yes No Does anyone smoke inside the NS home? Yes No

Would the student accept a twinning with a family where one or more people smoke? Yes No

ANIMALS Is the student able to live in a home with household pets? Yes No Specify:

WHICH CATEGORY BEST DESCRIBES THE STUDENT’S PERSONALITY:

Is the student : Outgoing Somewhat reserved Shy Specify:

ARTISTIC INTELLECTUAL ATHLETIC

ACTIVITIES

List three activities or pastimes of the student 1. 2. 3.

Student’s musical tastes: Specify:

Does the student play a musical instrument?

Yes No Specify:

Are there musical instruments in the home?

Yes No Specify:

Sports: Specify: h/week

Cultural and Social Activities Specify: h/week

Artistic Activities: Specify: h/week

Student’s level of French: Beginner Tourist Spectator Bilingual

Comments:

Does the selection committee recommend the student for the exchange program? Yes NoInterview Questionnaire 2016-2017 1 of 14

NOVA SCOTIA/QUÉBEC SIX-MONTH EXCHANGE PROGRAMSTUDENT/FAMILY INTERVIEW FORM

Interview Questionnaire 2016-2017STRUCTURE OF THE INTERVIEW1. The selection committee is comprised of two people (minimum): the Liaison teacher and at least one other person from the

school or school board. The committee members must consist of teaching staff or members of the school board. Should a family member of a student applicant be employed by the school board, all efforts will be made to form a selection committee without ties, direct or indirect, to the applicant.

2. One member (or two) of the selection committee is required to conduct an interview with the student applicant’s parent(s) or guardian(s) in the applicant’s residence where the Québec exchange student will be staying. In the event of a change of residence before the beginning of the exchange in September, a representative of the school or the school board will be required to evaluate the new residence before the exchange can take place. Please note that the selection committee will conduct two interviews in the case where the Québec exchange student will be staying in different residences while in Nova Scotia.

3. The interview will proceed in 3 steps:1. Individual interview with the student applicant in the school (Part A);2. Interview with the student applicant’s parent(s) and/or guardian(s)in the student applicant’s home (Part B);3. Interview with the student applicant in his/her parent(s) and/or guardian(s)’s home (Part B).

The length of each interview is at the discretion of the selection committee.

OBJECTIVES OF THE INTERVIEW1. To understand the motivation of the student applicant. Is the student applying because of family pressures, or does the

student want to participate in the program for personal reasons? Does the student understand the obligations and additional work required to participate in the program?

2. To evaluate the adaptability of the student. Can the student receive a partner in his/her home for three months despite what difficulties may arise? Can the student live three months in another province despite what difficulties may arise? Is the student outgoing? It is an important personality trait to consider before recommending a candidate. A timid or withdrawn student at home may have problems with such issues as loneliness or homesickness in an exchange situation and there is a good chance that he/she will become even more timid or withdrawn in Québec. He or she may have difficulties making new friends. This may also cause discomfort for his/her twin and host family and in his/her hosting school. It is not the host family’s responsibility to make a timid student more outgoing!

3. To evaluate the family and the residence of the student applicant. The family members must show all the moral qualities necessary to welcome an adolescent from another province into their home for three months. Are the living conditions in the host residence suitable (safety, cleanliness, hygiene, air quality, space, a separate bed for the exchange student, etc.)? It is imperative to request a tour of the house and assess the exchange student bedroom, the bathrooms, the kitchen, the living, and dining rooms area as well as the exterior of the house.) Do all the family members appear capable and willing to welcome a young person and make him/her feel comfortable for three months? Does the host family have the necessary financial means to host another teenager and involve him/her in various activities (cultural, athletic …)?

NOTES ON THE COMPLETE FILENOTE: The Department will not accept applications from students who have not had an in-home interview conducted

by the Liaison Teacher or one other member of the selection committee. There will be no exception to this requirement, even if the applicant is a relative of an employee of the school or school board or a member of the selection committee. The interview must be conducted with both the student and parent(s)/guardian(s) as specified in the following pages. Any disregard for the rules of the exchange will result in the school being excluded from participation in the program for one year.

4. All documents should be legible and all questions must be answered. The absence of any signatures or authorizations, the absence of an answer to one or more questions, a false declaration or any defamatory comments on the Application Form or Interview Questionnaire could result in the rejection of a student candidate.

5. Only files containing favorable recommendations will be submitted to the Provincial Coordinator. The remaining files will be retained by the school and destroyed at the end of the following school year.

Interview Questionnaire 2016-2017 2 of 14

NOVA SCOTIA/QUÉBEC SIX-MONTH EXCHANGE PROGRAMSTUDENT FAMILY INTERVIEW FORM 2016-2017

Interview Questionnaire 2016-2017

Please submit an electronically completed form as well two paper copies of this Interview Questionnaire

INDIVIDUAL INTERVIEW WITH THE STUDENT IN THE SCHOOL PART A

Location: Interview must be conducted in the school. DATE: 20 - - LENGTH: hours minutes It is important to read out loud all the notes that are included in the boxes of the questionnaire.

STUDENT INFORMATION

First Name: Last Name:

SCHOOL INFORMATION (school where the student applicant will be enrolled as of September 2016)

Name of School: School Board:

Address:

City: Prov.: Nova Scotia Postal Code:

Name of the Liaison teacher(s) [as identified by the School Principal]:

Telephone: ( ) - Ext: Cellular: ( ) - Fax: ( ) - Email:

1 FAMILY

Describe your family. List all your family members and residents in your home at the time of the exchange, your relationship to them as well as the ages of all your siblings:

2 ACTIVITIES and HOBBIES

What activities interest you? What are your favorite hobbies? Try to list them in order of preference. Do you have anything special you would like to share about your regular activities?

Note: The student must commit to spending most of his/her time with his/her twin during the 6 month exchange.

3 STUDENT EXCHANGE

What are your main reasons for wanting to participate in the exchange?

What kind of twin would you like to have (qualities, etc.)?

How would you feel if your twin has different interests than you?(It is rarely possible for the coordinators of the exchange program to pair two students who have all the same interests.)

Note: It is paramount that the student applicant avoids believing that his/her twin will de facto become his/her best friend. Many disappointments are caused by this expectation. It is essential to discuss this point with the candidates and their parent(s)/guardian(s) during the interview.

How do you feel about living in a new or different environment for three months (language, family structure, friends, school, culture, meals, etc.)?


How do you think you will react to living away from your family, friends, and school for three months? Will you be able to significantly reduce contact with them by phone and other electronic means?

4 SCHOOL WORK

What strategies will you use to stay on course with your Nova Scotia school work while pursuing studies in Québec for three months?

5 KNOWLEDGE OF FRENCH

How many years have you been studying French?

In which French programs are you presently enrolled; at what school did you first register in this program and at what grade? (Early or Late Immersion, Integrated French, Core French, IB Program, CSAP schools)?

Are any members of your family or household francophone? Explain If so, do you usually speak French at home? Yes No

The members of the selection committee should evaluate the student’s language competencies in French. They might choose to ask the student to read a French text and then ask some questions regarding the text, or they might discuss the student’s aspirations as far as the exchange is concerned.

Evaluation: Excellent Good Medium Weak

Please assess pronunciation, expression, understanding and extent of vocabulary

Evaluation: Excellent Good Medium Weak

Comments:


INTERVIEW WITH THE PARENT(S) OR GUARDIAN(S) ALONE PART B

Location: This interview must be held in the home of the parent(s) or guardian(s) (where the exchange student will be living). It is important to read out loud all the notes that are included in the boxes of the questionnaire. Ask to tour the residence where the host student will live.

DATE: 20 - - LENGTH: hours minutes

INDIVIDUALS MET IN THE HOME DURING THE INTERVIEW:

Parent 1 Parent 2 Guardian (describe relationship to the student): Other individual present (please explain link to the student)

Was someone absent during the interview at the house? Yes No Who?

When will you meet them?

1 PERSONALITY OF YOUR CHILD

Describe how well the following character traits apply to your child’s personality:

Sense of humour Yes No

Sensitiveness / touchiness Yes No If Yes, how does it present itself?

Timidity / shyness Yes No Withdrawn Yes No

If your child is shy or timid, please explain how this will not be an issue in a new environment: Adaptability Yes No

Describe your child’s ability to adapt to a completely different environment where he or she will encounter differences in culture and new experiences (language, school, family, food, friends, etc.):

Sociable Yes No Please explain:

Respectful Yes NoResponsible Yes NoCooperative Yes NoGenerous Yes No

How well will your child accept a new type of parental authority, for instance if the discipline in the host family is stricter or less strict than your own?

Will your child accept household chores enthusiastically, as required, in the new household? Yes No

Does your child have a boyfriend or girlfriend? Yes NoIf yes, how do you think this will affect the attention and time your child will offer to his or her twin? What are the family rules about visits by or with the boyfriend or girlfriend?

2 HEALTH

Does your child have any physical or mental health conditions? Yes No If Yes, please specify:

Should the host family and the school be selected for your child be informed of this issue? Yes No

Please describe briefly the state of health of other family members who will be present in the home during the exchange:

Does your child have allergies? Yes No

If yes, please specify the conditions that cause issues (e.g. types of food, animals, plants, etc.)


Is your child currently taking prescribed medication Yes No If yes, please specify: If your child requires medical attention while in Québec, should the physician be made aware of any specific health-related concerns? Yes No If yes, please specify: Does your child follow a special diet (i.e. vegetarian)? Yes No If yes, please specify:

Does your family follow a special diet? Yes No If yes, please specify:

Note: Should there be a change in the health status of your child or a member of your family, you must advise the Liaison teacher as well as the Québec family during the summer.

3 THE STUDENT EXCHANGE

Have you ever hosted an exchange or international student in your home before? Yes NoPlease explain:

What are your personal expectations of the program? What are your reasons for involving yourself and your child in this exchange program?

During your child’s absence:

How do you think you will react during the absence of your child from February to April?

Do you think your child will be homesick to the point of wanting to return home prematurely? Yes No

Comment:

Using a rating of 1 to 10 (1 = Not at all, 10 = To a great degree), please answer the following question:

To what extent will you miss your child? Father/Guardian Mother/Guardian

If you miss your child, or he or she is homesick, do you think that you would persuade your child to return to NS? Yes No

Please explain your answer:

Has your child been away from home for a long period of time before? Yes NoIf yes, please describe where, for how long and the circumstances?

In your opinion, what is a reasonable amount of contact with your child while they are away and what method of contact will you use (texting, email, phone, FaceBook, Skype, etc.)?Please explain your answer:

Note: It is not beneficial for the student to contact home and friends too frequently; young people may experience greater homesickness, have difficulties settling into their new environment and therefore become quite vulnerable. With the growing number of personal computers and social media tools in family homes and schools, it becomes very easy to communicate. It is strongly recommended to limit the communications (cell phone, e-mails, texting, Skype, etc.) between the student and his/her family and friends to once per week.

4 PRESENCE OF THE QUÉBEC STUDENT IN YOUR HOME

Briefly describe how you see your role as a host family for the Québec student:


Describe activities that you might organize or offer your student in order that he/she become more familiar with Nova Scotia, life in NS, culture, etc.: It is expected that at all times at least one of the parents or guardians be present at home while the Québec student is in your host home to ensure his or her security. We are not talking about workday-related absences or regular social outings. The concern is about a full weekend or several days of absence by both parents and guardians. Do you think you can ensure this level of security? (This would be a good occasion to bring up the Criminal Check and Child Abuse Registry requirements for all adults over 18 living in the house while the exchange student is present.)Do you feel that having another young person in your home for three months will be financially difficult for your family?

Yes No

If you answered yes, please explain:

Note: The family who receives a Québec student must agree to provide a completely English speaking environment, as this is a program to enhance language skills and cultural awareness. English should be the language spoken at home, during activities, in conversation and on television programs. The family should also commit to involve the exchange student in family activities and other cultural or various other activities.

5 TRANSPORTATION

Is public transportation easily accessible so that your child and the Québec student will be able to participate in various activities?

Yes No

If not, how will your Québec student be able to participate in the social, cultural and athletic activities that may be of interest?

6 ALCOHOL and SOCIAL ACTIVITES

How will you feel if your Québec student takes the initiative to organize acceptable activities or visits for himself or herself while living with your family? What are the family rules concerning the consumption of alcoholic beverages?

In the home: - Outside the home:

Do you have any particular restrictions or expectations in regards to going out, visiting or other leisure activities?

Yes No

Please explain: Please indicate the activities that you permit your child to participate in, and when he/she is expected home

School night:

Weekends:

School holidays:

Note: You, as a host family, will assume all local costs including school lunches and any transportation for your visiting student (other than the trip to and from Nova Scotia at the point of arrival and departure). However, this does not include pocket money, which is the responsibility of your visiting student’s parents.The use of drugs and alcohol IS NOT permitted during the exchange. Any use of drugs or alcohol by students involved in the exchange will mean the automatic cancellation of the exchange and the student will be returned home at the parents’ expense.

7 PERSONAL APPEARANCE

Is personal appearance (jewelry, fashion trends, etc.) important to you? Yes No

Do you have any expectations with regard to the exchange student’s manner of dress? Yes No

Please be specific:


8 RESIDENCE

If you are a single-parent family or a blended family, indicate the address where the twined student will live for the three-month period in Nova Scotia:

Father or guardian OR Mother or guardian

Address:

City: Prov.: Nova Scotia Postal Code:

Telephone (home): ( ) - Telephone (work): ( ) -

Note: In the event of shared custody, the parents or the guardians will have to provide both residential addresses in Nova Scotia. Any change at these addresses after the interview will have to be immediately transmitted to the Liaison teacher. We ask the parents not to make one week alternating custody arrangements during this period but to divide the three months living arrangements in two.

Do you have any comments, questions or apprehensions concerning the fact that a new teenager will live in your home for a three-month period?

Although the exchange student must be given priority for the duration of the exchange, the partners do not have to be together constantly. The exchange student is to be considered a member of the family, with the freedom to choose his/her own friends. This is an important factor for a successful exchange. It is also important that your child understands that the Québec twin may not necessarily become his or her new best friend. Your child may feel disappointed if this expectation is not met.


Please ask the student to join in on the conversation9 QUESTIONS REGARDING THE EXCHANGE STUDENT

Do you expect the exchange student to do chores while staying in your home? If Yes, specify:

What sort of chores is your child presently expected to do?

Do you give your child an allowance for doing chores? Yes No

Would your child be cooperative in doing chores in the Québec household if no allowance is provided?

Yes No

If No, please be specific:

QUESTION TO STUDENT

Briefly explain how you would react in a family whose rules are stricter (strict curfew, limits on going out, limited television or computer access, etc.):

QUESTIONS TO THE PARENT(S) OR GUARDIAN(S)

Describe your typical family leisure activities:

During the weekend:

During holidays of 3 days or more:

Is religious practice important in your child’s life? Yes NoIf yes, please specify your religion or denomination: If the religious practice of the exchange family is different than your own, how will you feel?

Religious services attendance is on the decline in Québec and more than likely, the Québec student will not be attending any religious services. Is that an issue? Yes NoWill your child be expected to attend a religious service when he or she is in Québec? Yes NoIf so, please specify.

Have you planned a visit to your child during his or her stay in Québec? Yes NoIf this is the case, please explain:

Note: The Exchange Program coordinators strongly advise against visiting your child while on exchange. Often such visits are difficult for host families for a number of reasons including language and the sense of needing to provide hospitality. The visits also disturb exchange students by causing homesickness and prolonging the adaptation period. We recommend that any visits to the host family take place during the summer following the exchange, and that you make your own arrangements for hotels and activities.

Do you have any comments, questions or apprehensions concerning the Nova Scotia/Québec Six Month Student Exchange program in which your child wishes to participate? Are there any restrictions which you would impose on your child or on the Québec student during the exchange beyond those required by the program?

QUESTION TO STUDENT

Are there places in your community, other than the school that you attend, where you can easily meet other people your own age? Yes NoIf yes, please explain where and how: Although the exchange student MUST be given priority for the duration of the exchange, the twins do not have to be together constantly. The exchange student is to be considered a member of the family, with the freedom to choose his/her own friends. This is usually important for a successful exchange.To both parents and studentWould you consider hosting a student of the opposite sex? Yes NoIf yes, what conditions would you impose? Do you have further comments or questions? Is there anything else that you would like to share with us about you, your family, your community or your school that would help us find the best twin for you?


INSTRUCTIONS TO READ AND DISCUSS WITH THE PARENTS AND STUDENT AT THE END OF THE INTERVIEW

1. A family that accepts participation in the exchange must have at least one of the two parents/guardians in permanent residence at the home for the duration of the program, including when your child is in Québec. Any disregard of this rule will cause automatic cancellation of the exchange.

2. The parents must inform the Liaison teacher if they separate or if the student will have to change schools or homes before the end of the exchange.

3. By accepting the student’s application, the Department does not guarantee participation in the program. The exchange depends on finding a compatible twin from Québec and on the exchange being accepted by all parties involved.

4. Students participating in the exchange are required to follow all rules and complete all work required by their school in Québec. They are also required to complete all work required for completion of their grade in Nova Scotia. (Completion of this work should mainly take place either before or after the stay in Québec). Every effort will be made to find comparable courses but it is not always possible. Please note the Québec schools are not semestered and that their mathematics curriculum is one year ahead of the Nova Scotia mathematics curriculum.

5. It is strictly prohibited for NS students to receive NS friends while staying with their Québec family. This rule particularly concerns visits from boyfriends or girlfriends.

6. Visits from family and friends of the family are strongly discouraged especially when it would involve extended separation of the NS student from the host family.

7. This program is intended to give the exchange student new language skills and exposure to a new culture. A NS family accepting participation in the exchange must provide the Québec student with an entirely English language experience. English must be the language spoken inside and outside the home for the duration of the Québec student’s stay. Television and radio programs should also be in English. The family should also occasionally involve the student in cultural and other various activities.

8. If the exchange is cancelled for misconduct or at the request of the student or parents for reasons not condoned by the program, the parents will be responsible for paying their child’s return airfare home.

9. Living conditions comparable to those represented in the home during the interview must be maintained for the duration of the exchange. If there are any changes, the Liaison teacher and the Provincial Coordinator must be informed immediately. Cancellation of the exchange could result.

10. Students are not permitted to miss classes at the exchange school without a valid reason. Absences must be approved by authorized school personnel.

11. The $100 registration fee will be reimbursed if a suitable twin in Québec is not found.

12. A NS family that accepts participation in the exchange will be required to complete a Child Abuse Register-Request for Search and a current police reference/records check.

13. The Nova Scotia Exchange Program Coordinator will visit your school when your twin arrives in September in order to support the school in harmonizing the curriculum for the Québec student as well as reviewing your own course selection. He will also travel with you in February and visit you in your Québec school within a week of your arrival in order to make sure that you are doing well and also to support the Québec school in harmonizing your curriculum with the Québec curriculum.

14.

15.

Even though your application is accepted and submitted to the Program coordinator at the Nova Scotia Department of Education and Early Childhood Development, the process will not be finalized until a suitable twin is found for you and both families and schools have accepted the twinning arrangement. A student and his or her family can only refuse a twinning arrangement once and only for serious reasons that are deemed acceptable by the Exchange program coordinator.

The Quebec/Nova Scotia Student Exchange program is considered a critical service under the Nova Scotia Department of Education and Early Childhood Development emergency management plan. In the event of a declared disaster or emergency situation, the host family has the responsibility to provide safety and security for the exchange student until EECD makes timely arrangements to safely collect the student and organize his or her transportation home.


If, after completion of the in-home interview, you feel the student applicant and his or her family should be considered for acceptance in the program, please have the parent(s)/guardian(s) and the student sign the consent form on the following page, and include it with all other relevant forms submitted to the Program coordinator. Then complete the report, including the summary, sign it and ask the principal of the school to sign it as well.

PARENTAL AND STUDENT CONSENT

First Name (Student): Last Name (Student):

School Board:

Name of the school:

1. We understand the objective of the Nova Scotia/Québec Six-Month Exchange Program and the conditions for participation. In particular, it is understood that we will receive a student from Québec and are expected to provide an entirely English environment as well as guarantee that English will be the language spoken in the home and during any other activities while the student is in Nova Scotia.

2. We accept our role in the program and all the responsibilities it entails. We will not drop out of the program except under exceptional circumstances, and then only after prior consultation with the Liaison teacher and the Provincial Coordinator.

3. We understand that this interview questionnaire will be assessed by the selection committee in our child’s school and by the Provincial Coordinator at the Nova Scotia Department of Education and Early Childhood Development. We understand that should our child be accepted as a candidate every effort will be made to find a suitable twin among the Québec exchange student candidates. For this purpose, we grant permission so that all the information compiled in the final report will be communicated to the Provincial Coordinators and, thereafter, with the parents of the hosting family as well as the hosting school.

4. In the event that the exchange must be terminated before the end of the program, we understand that we may be responsible for our child’s return airfare home.

5. We have had the chance to review the answers we gave to the questions during the interview with the selection committee.

Date Student – Print Name and Sign

Date Parent 1 (Guardian) – Print Name and Sign

Date Parent 2 (Guardian) – Print Name and Sign

Note: The entire file is comprised of the completed application form, the completed interview questionnaire, the summary and the completed selection committee evaluation form.


SELECTION COMMITTEE FINAL EVALUATION

First Name (student): Last Name (Student):

NOTE:This program is for students who are outgoing and confident. It is not for timid and withdrawn youth as the experience may prove overwhelming for them and the host student, family and school. Such students often suffer from homesickness and loneliness. It cannot be expected that the host family and school will be able to achieve what the student’s own environment could not do. The selection committee should be particularly aware of solitary students who have very few friends, have weak communication and interpersonal skills, and spend most of their time involved in individual activities such as watching television, reading, playing video games, shopping and surfing the Internet. The committee must reject a candidate for whom they feel the program may prove to be emotionally overwhelming.NOTE:1. The committee tries to evaluate and to select the host family according to three factors: (1) The absence of the child for

three months. Will the parents miss the child so much that they will insist that the child return or vice-versa? (2) The presence of a new teenager in their home for three months. If the couple does not get along, or is about to separate or will not be in their home, this is probably not the best time for them to receive a new student into their home. (3) The residence of the host family is very clean and safe.

2. Parents are advised that a change in the family / marital status (ie: separation) or a move of residences risks cancelling the exchange between students.

3. Verify if it is the family who is insisting that their child take part in the program in spite of what the child wishes. If this is the case, the application must be rejected.

STUDENT EVALUATION: please specify your answers:

1. Personality:

2. Appearance:

3. Knowledge of French: 4. Sociability:

5. Adaptability:

6. Motivation:

7. How the student will be perceived by his hosting family and school:

8. Possible problem areas:

9. Comments:

PARENT/GUARDIAN/FAMILY EVALUATION: DOES THE COUPLE APPEAR HAPPY AND STABLE? Yes No

Positive comments:

Negative comments:

2. IF IT IS A SINGLE PARENT OR A BLENDED HOUSEHOLD, DOES THE ENVIRONMENT IN THE HOME APPEAR HARMONIOUS? Yes No

Positive comments:

Negative comments: Note: Where separated parents share guardianship of their child, how will the exchange student and child’s living accommodations be organized? (It is required that the two students live in the same house throughout the exchange or at least six weeks with the father and six weeks with the mother. If this is not possible, the exchange will be declined. However, this does not mean that regular visits cannot occur). 4. DESCRIBE THE FAMILY HOME IN WHICH THE EXCHANGE STUDENT WILL BE STAYING, IN PARTICULAR ITS

STATE OF CLEANLINESS, WELCOMING ATTITUDE, OPENESS TO HAVE HOST STUDENT PARTAKE IN FAMILY

ACTIVITIES AND ACCESSIBILITY TO FOOD AND WASHING AND DRYING MACHINES :


1. COMMITTEE CONSIDERATION OF THE STUDENT CANDIDATE

First Name: Last Name: Excellent Very Good Good Not recommended

2.NOU COMMITTEE CONSIDERATION OF THE HOST FAMILY

Excellent Very Good Good Not recommended

3. WOULD ALL THE MEMBERS OF THE COMMITTEE FEEL COMFORTABLE SENDING THEIR OWN CHILD TO LIVE WITH THIS HOST FAMILY FOR THREE MONTHS?

Yes No

Comments:

4. IF THE STUDENT IS SHY OR TIMID, WHY IS HE/SHE STILL BEING RECOMMENDED TO PARTICIPATE IN THE EXCHANGE?

Comments:

RECOMMENDATION (please check the appropriate box)

The committee RECOMMENDS the student for the Exchange Program

The committee DOES NOT RECOMMEND the student for the Exchange Program.

*(In this case, the student’s file does not need to be submitted to the Program Coordinator)

*

COMMITTEE MEMBERS(Minimum of two people)

First Name: Last Name: Position:

Signature: Date:


Signature: Date:


Signature: Date:

PERSON IN CHARGE OF THE EXCHANGE PROGRAM AT THE SCHOOL


Signature: Date:

RESPONSIBLE SUBSTITUTE IF THE LIAISON TEACHER IS UNABLE TO FULFILL THEIR DUTIES


Signature: Date:

SCHOOL PRINCIPAL (Required)


Signature: Date:


List of documents required for submitting the final registration file

The completed file must contain the following documents:

Nova Scotia/Québec

Print-out of the original computer completed version (Word) plus a second paper copy of the file in this order: summary, student application form (colour print-out of the pages containing photographs), interview questionnaire and final report, including the photograph of the student and the other required photographs. No hand written application will be accepted.

One electronic version (PDF) of the summary, student application form, interview questionnaire and final report with the photographs requested. The file must be emailed with the following file name: (Student) First Name, Last Name, school, school board.

Copy of the student’s birth certificate.

$100 cheque (non-refundable registration fee), made payable to the “Minister of Finance”.

This information should be received at the Department of Education and Early Childhood Development by March 31, 2016 .

Please forward the paper copies to:

Provincial Coordinator, NS/Québec Exchange Program

Department of Education and Early Childhood Development

French Second Language Division

PO BOX 578, 2021 Brunswick Street

Halifax NS B3J 2S9

Please forward the electronic documents to:

[email protected]

As the liaison teacher will be required to work beyond normal teachers’ hours to support the selection process and to provide continuous support for the exchange students, the liaison teacher will receive a $185 stipend per exchange student from his or her school at the completion of the program.

Thank you!


mailto:[email protected]

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