Please note that the information and instructions on this website only reference procedures for Rotary International districts located within ESSEX (east coast of USA, Bermuda and eastern Canada).   To see if you live in the ESSEX area CLICK HERE to view the list of ESSEX Districts and Rotary Clubs.


 How to Apply 

 If you are interested in becoming a Rotary Youth Exchange student, please contact your local Rotary club. Once you have contacted a club an interview will be scheduled for the student.  If the Rotary Club feels you would be a good candidate for exchange you will then be asked to complete the application and referred to the Rotary District Youth Exchange Chairperson in your area. The chairperson may not be located in your hometown because he or she coordinates the program for a larger region, which is called a district.   The district will conduct an interview with you and your parents.   


If you need help locating a rotary club please call 1-888-ROTARY-X (1-888-768-2799).


When to Apply

As the Rotary Youth Exchange program is highly selective, you should apply early — up to a year in advance of when you wish to leave. For example, for long-term exchanges, selection takes place in the fall prior to the year you will make your exchange. If you wish to travel abroad during your junior year, you should apply in September of your sophomore year.  Once you are selected, your sponsoring Rotary club and district will work to prepare you for your year away. You will be guided through a series of orientation sessions, preparing you for your exchange.


Long-Term Application Download


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

Long Term Application Packet....................... 

Download the Application >>  (revised NAYEN 2020-21)                           

ESSEX Outbound Student Rules and Conditions of Exchange OB 1710


Download the Application Form, ESSEX Outbound Student Rules, Indpendent Travel and Country Selection List.

To begin the application process, download the forms listed above, used by Rotary districts in ESSEX.     This application allows you to complete and print many parts of the application using your computer. 

Other parts of the application form, like the recommendation forms and medical forms, must be completed manually.

Be sure to print this website page before filling out the application since you may need to refer to these instructions as you fill out the form in Adobe Acrobat.

NOTE:  please contact your local Rotary club BEFORE completing this application. Some clubs have additional application forms and/or rules.  

Fill Out the Application: General Instructions

Open the application form on your desktop by clicking on the “Download the Application” link. Save it to your desktop.

Open the application form using Adobe Acrobat Reader. Upon selecting a location on the form, an "insert" cursor will appear on any data line that can be filled in using the computer. The cursor will appear as a "hand" for locations that are not available for data entry. It is possible to use the "tab" key to step through the form (except for check boxes) as a simple way to fill out the form. Any information the form does NOT permit you to fill out (like medical evaluations and school recommendations) should be given to the appropriate person for completion. You can fill out basic information on the medical evaluations like the doctor's name in the form.

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

Print at least 2 copies. You are required to submit a minimum of 2 original copies of the application, but your Rotary district may require more. All copies must have original color photos and original signatures. All signatures must be in blue ink.  


One original OFFICIAL Transcript and 3 copies are mandatory.  Please check with your High School guidance counselor to secure your OFFICIAL transcript.  To be official, a transcript must have the school's raised seal on it.


PLEASE NOTE: If you are applying to go to France: France requires that you complete one copy of the application in French. In order for us to forward your application to France, you must complete the attached copy and return it with your ESSEX Application.


Long Term French Application>> Download the Application

Directions for filling out the French Application

ESSEX Rules in French



Apply for Medical Insurance

All students are required to carry the CISI-Bolduc medical insurance and MUST purchase it prior to departing for their exchange, even if you have other health insurance.


To enroll online by credit card, please click here:



To download the insurance application and for coverage details please click the following link:

Deliver the Application

Keep one copy of the application for your files.  Deliver your applications to the local Rotary club so the District interview, can be scheduled.

Associated Fees

Your Rotary District will advise you the cost of the program, prior to or during interview process.   If you have any questions concerning the cost of the program please contact your local Rotary Club or Rotary District.

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.   For Passport information click here.