Evaluation of Applicants - Form C
To be completed by the liaison teacher and and/or selection committee members following the interview process of each applicant host family - one form per family interview.

Assure the student has completed and submitted their application and letter of introduction for the Nova Scotia-Québec Student Exchange Program (Forms A & B).
Student Name: *
Your answer
School Name: *
Your answer
School Board *
Liaison Teacher Name: *
Your answer
Selection Committee Member(s) *
You must include a minimum of one other member
Your answer
Demonstrates an ability in adapting to new situations *
Student & Family
Strongly Disagree
Strongly Agree
Demonstrates openness towards other people and cultures *
Student & Family
Strongly Disagree
Strongly Agree
Demonstrates maturity and sense of responsibility *
Student
Strongly Disagree
Strongly Agree
Demonstrates a sense of humour and positive behaviour *
Student
Strongly Disagree
Strongly Agree
Exemplifies an above average academic standing *
Student
Strongly Disagree
Strongly Agree
The home is clean and safe *
Strongly Disagree
Strongly Agree
The Parents and/or Guardians welcome a new addition to their family for three months *
Strongly Disagree
Strongly Agree
Please comment on your overall assessment of the student and family unit. *
Your answer
I/We certify that the information provided in this evaluation is true, correct and provided in good faith, and that any falsification in any way may exclude my school from being considered for the NS-Québec Exchange Program. *
Required
Submit
Never submit passwords through Google Forms.
This form was created inside of GNSPES/SEPNE. Report Abuse