Quarterly Report Is Due December 1st

Last Name
First Name
Current Street Address
Current City
Current Zip Code
Current Phone Number
Your e-mail Address
Current Host Parents (First and Last Names)
Host Rotary Club
Rotary Counselor's Name
Counselor's Phone Number
Are you receiving your stipend?	YesNo
Amount of Stipend
Are you attending meetings?	YesNo
How often?
Have you presented?	Yes No
If not, when?
Have you traveled outside your area?	Yes No
If yes, where?
Please use the space below to write a little about how life is going. What new foods have you tried? How is school? What classes are you taking? Are you participating in sports? Have you gone on any trips? let us know what is new and exciting for you. We will share this in a newsletter to all your exchange student friends. Send photos by e-mail to janice.newman@suddenlink.net, or mail them to Janice Newman, 2870 Dunbar Ct., Arcata, CA 95521. They will be returned.