Inbound Student Acceptance Form – Rocky Mountain Rotary Youth Exchange

Inbound Student – RMRYE 5450 Placement Acceptance

Name*
First Last
Email*
Phone*
Gender*
Mailing Address For Guarantee Form*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Parent 1*
First Last
Parent 1 Email*
Parent 1 Phone*
Parent 2 Name*
First Last
Parent 2 Email*
Parent 2 Phone*
Home Country*
Sponsoring Rotary District Number*
Sponsoring Rotary Club Name*
I understand my Guarantee Form will not be mailed until my family and I have signed the required documents.*
- Yes
These will be sent electronically in May.
I understand my Guarantee Form will not be mailed until I purchase insurance for the exchange year.*
- Yes
After you submit this form you will receive a series of emails to sign the required exchange documents electronically. These will include: Exchange Agreement: General Rules, Exchange Agreement: Family Visit, Mandatory Dates and the RMRYE 5450 Travel Policy
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exchange type*
This field is hidden when viewing the form
exchange year*