Rotary D5050 Youth Programs

Host Family Application



The Rotary Youth Exchange Program appreciates your interest in hosting an exchange student, and we are confident that this will be a truly rewarding experience for you.

Rotary International and our local Rotary Clubs requires that we obtain the information on this form and conduct background checks on all potential host families. We assure you that the information that we receive will be treated confidentially, and we thank you for your assistance and understanding.

Your host Family Application will comprise of the following:
  • Contacts and Information about you and your family
  • Three personal references- you will need full name, email address, and phone number.  The system will email the reference directly, no further information is needed. 
  • Photos of your home; Exterior, Student Bedroom, Bathroom, Livingroom or Family Room, Kitchen and a Family Photo
  • Information about your local school; address, student body size, start date, distance and how your student will get to school.
  • Information about your community
  • If you have anyone living on your property that is over 18 years old, they will need to be added to your application. 
Once you have submitted your application you will be contacted by a local Rotarian.  Some additional training and home visits are required and will be scheduled by your local Rotary Club.