Rotary Youth Exchange Outbound Application Inquiry for District 5970
Complete this form to receive futher information on applying to be a Rotary Youth Exchange Student for next year.  Once this information is completed, a member of our team will review and respond to you.  If you do not hear back within a week, please email 5970rye@gmail.com with the subject line "Outbound Application Request."
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Email *
Full Legal Name *
Nickname/Preferred Name (if any) *
Current Year in High School *
Year of High School during Your Exchange Year (next year) *
Age (Year and Months) at the time you expect to leave on your exchange, usually in the next year in August).  Example:  17 years and 6 months *
Phone Number *
Email Address *
Rotary Club(if not known... what city do you live in?) *
Have you been in contact with your local Rotary Club yet?   *
In about 3-5 complete sentences, please tell us why you are interested in apply to be a Rotary Exchange Student for next year.   *
Rotary Youth Exchange does not guarantee that you will be selected for the country of your choice.  District 5970 has established relationships with over a dozen certified countries, and the district committee will select a country that they deem is best for your exchange.   *
Of the following countries, which are your top three choices for an exchange? *
Required
Can our District 5970 Team share your contact information with your local Rotary Club so that they can contact you directly?  *
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