This page is for use by clubs’ youth exchange administrators and is provided to assist clubs in administration of the youth exchange program.  

The District Committee’s goal is to improve documentation of the program and the administration process. The forms and policy documents are in the process of being streamlined and updated to meet this objective.

The Committee appreciates your partnership in this improvement effort by notifying the appropriate District Committee member of any suggested improvements to forms and policies that would improve the program and streamline the process. See our Contact Us page.

*CISI INSURANCE INFORMATION*

CISI Insurance Brochure 25-26

CISI Claim Form

CISI Insurance Fact Sheet

CLUB FORMS

Required for participation in D5080 Youth Exchange

Annual Club Compliance Certification* – for the US and Canada due October 30th: 

1.03 Club Compliance Certification Requirements

*SCRYE Club Compliance Form for US and Canadian Clubs. 

1.57 Annual Club Youth Exchange Agreement Form – Oct 2024

 SCRYE forms and downloads page

NAYEN Long Term Application Form and Instructions – 2024 For Reference only

NAYEN Student Tips for Long Term Application 2024

1.52 Club Suggested Youth Exchange Budget

YEAH Volunteer Application-YEAH Volunteer Form. For all Club members with significant and/or one on one contact with youth exchange students) 

Student Application Flowchart

Long Term Outbound application 2026-2027 outbound year

Short Term outbound application 2026-2027 outbound year

D5080 YEO YEAH Training

1.53 Club Youth Exchange YEO Monthly Checklist 9-24

1.56 Forms and Documents Expiry

2.12 Outbound Application Preliminary Medical Questionnaire

Short Term Medical Declaration Form Oct 25

2.52 Outbound Student Financial Agreement

Short-Term Program Financial Agreement 2023.11.29

Short Term Club Interview – Questions for Students and Parent 10-14-25

District 5080 Student Travel Policy  11-7-24

3.08 Student Travel Permission Form 11-7-24

5.54 District 5080 Short-Term Brouchue Sept 2025

Student Data for Business Cards

CUSTODIAN DECLARATION FOR MINORS STUDYING IN CANADA – FORM

Due March 15th

Rotary Youth Exchange Handbook

Please verify you are using the most recent form prior to submission.  The date of the most recent revision is either on the bottom, left or top.  Forms received on an old version will be returned.

* By submitting this form, your club is agreeing to comply with the policies and procedures of the District 5080 Youth Exchange Committee as specified in the Club Manual below.

Outbound Student Responsibilities

Being chosen as a Rotary Youth Exchange Student is an honor and a privilege. Along with this honor and privilege come responsibilities.

Outbound Student Commitment Form

GUIDES, BROCHURES, POSTERS

1.12 GLOSSARY OF TERMS AND ABBREVIATIONS USED IN YOUTH EXCHANGE

Guide for Exchange Students (RI)

Youth Exchange Handbook (RI)

Long Term Exchange Brochure (RI)

Guide for Host Families (RI) Download Document

District Host Famiily Handbook 2022

**Host Family Application

**NOTE Those applying as a Host Family, use the Host Family Appication only

SCHOLARSHIPS

About Our Low-Cost Scholarship Programs Tailor-Made For You NAYEN SITE

After acceptance, your sponsoring club can apply for the District’s “Conger Memorial Scholarship.”

Conger Memorial Scholarship Application 3-20-24

Due March 1st

Youth Exchange Assistance Scholarship (YEAS)

YEAS Application and Financial Statement 2024-2025

Other forms and applications

Exchange Student Travel Permission Form

District 5080 financial Agreement Form

2.57 Power Point Long-term Exchange 2024-2025 9-19-23 update

CSRYE promotional videos with interviews of exchange students and host families  

Rotary International Code of Policies November 2020