Long-Term Exchange Application
>> Download the Application >>


Before You Begin

Before you begin the application process, you should review the rules and conditions required of long-term exchange students to ensure that you can abide by them and be aware of the orientation requirements that you will be required to meet before you go abroad. You should also be prepared with sufficient medical insurance and be aware of how your travel arrangements will be handled. Links from this page will provide you with background on these items. You may also want to review those countries that have special requirements to ensure that you can meet those for the countries you’re interested in.

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, you will then be directed to the Rotary 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 chairperson will conduct an interview with you and have you fill out an application form. Once you have completed your application and interviewed with the district chairperson, the application process is complete.

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. If you are wondering why it is necessary to apply so early, 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 so you'll be ready for your new life in a new country.

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.

Download the Application: http://www.rotary.org/newsroom/downloadcenter/pdfs/761comb_write.pdf

Download the Application Form

To begin the application process, you should click here to download the long-term exchange application
used by most Rotary districts in ESSEX by clicking here. 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. The application should then be sent by mail with photographs
and other required documents.

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: Also please contact your local Rotary club BEFORE completing this application.
Some clubs have additional application forms and/or rules. If you live in the ESSEX area,
you may call our toll free number (1-888-ROTARY-X) and leave a message. Your message
will be forwarded to your local Rotary club and you will be contacted shortly.


Fill Out the Application: General Instructions

Open the application form onto your desktop by clicking on the “Download the Application”
link at the top or bottom of this page. This will automatically download the pdf file (LTEPApplication-20070-USA-CanadaVersion-Save.pdf). 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 and phone number of your
local Rotary Club chairman and your district chairman. E-mail addresses are greatly appreciated.
ALL applications must be typed. It is easier to read and faxes better. Scanning pictures onto
the first and last pages works well.

PLEASE NOTE: You cannot save parts of the application that you have filled in on your computer.
You must print the pages that you have completed before you quit out of the file or you will
lose the work you have done on them. If you find a mistake on a page and have already exited
the form, you will have to retype and reprint that page.

Additionally, 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 at least 6 copies. You are required to submit a minimum of 4 copies of the application,
but your Rotary district may require more. All copies must have original color photos and
original signatures. You and your parents should sign all copies with blue ink.

You have already completed your country choices on the application, 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 sufficient exchange
places for a specific country. When this happens, having several options helps find you a suitable match.


Fill Out the Application: Page-by-Page Instructions

This is a list of the blanks you may fill in electronically on each page of the application:

• Page 1:With the exception of the signature lines, just about every field, including name, addresses
and phone numbers can be completed using the computer.

• Page 2: The whole top section titled "Secondary School & Personal Information" can be completed.
Please note the check boxes, including the boxes next to language fluency, can be completed using
the mouse. The lower section of the page must be completed by your principal or guidance counselor.

• Pages 3-4: Under the "Medical History and Examination" section, you should complete your name,
address and sex. The remainder of page 3 and all of page 4 should be completed by your physician.

• Page 5: You may enter your full name at the top of the page, your dentist’s name and phone number,
your name and your parents’ names in the medical release section and the emergency contact information
at the bottom of the page. The remainder of the information should be completed by your dentist.

• Page 6: (blank).

• Page 7: The district and club chairmen’s names should be completed by your club. You may type in
the information in the "Student" section.

• Page 8: (no typing necessary)

• Page 9: Please complete all information in the top three lines of the guarantee form fully.

• Pages 10-12 do not require typing. You should read them closely and sign the appropriate places.

• Page 13: Type in the information requested in the top two lines of the "Confidential School Reference".
The remainder of this form should be complete by your teacher, guidance counselor, etc.

• The remainder of the application does not require typing.


Apply for Medical Insurance

All students are required to carry the ESSEX-sanctioned medical insurance. To enroll online by credit card, please click here: webapps.aifs.com/RotaryOnline/. To download an application and submit by mail or fax, please click here: www.cisi-bolduc.com/rotary_app.htm. Short-term exchanges MUST take the 3-month short-term Plan B as a minimum.


Deliver the Application

Keep one copy of the application for your files. Mail or deliver your application 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 Long-Term Chair or Youth Exchange Chair will sign
your application before it is sent onto ESSEX and a Rotary club in the host country.


Pay Associated Fees

At some point, you will need one or two checks with your application to the club or after
your application is accepted by the district:

• One made out to CISI-Bolduc for the amount of the insurance.
• One made out to your Rotary district for the district fee.


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. Get more Passport information here.


>> Download the Application >>

> Rules and Conditions of Long-Term Exchange
> Long-Term Travel Arrangements
> Long-Term Medical Insurance
> Long-Term Orientation
> Countries with Special Requirements