Rotary Youth Exchange Inquiry
Please complete this form if you are interested in learning more about participation in Rotary District 6510's Youth Exchange Program. A member of the Rotary program will follow up with you.
Full Name of Student *
Your answer
Current High School *
Your answer
Planned High School Graduation Date *
Your answer
Student email address *
Your answer
Student Phone Number
Your answer
Primary Parent or Guardian's Full Name *
Your answer
Parent email address *
Your answer
Parent Phone Number
Your answer
Have you ever visited a foreign country? If so what country or countries?
Your answer
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