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EXCHANGE PROCESS Please carefully read each trip description on the following pages to determine whether you are: 1) qualified by age group; 2) able to home host an international student if required; 3) available on the trip dates.

Application deadline is Wednesday, October 20

Cost Includes: Round-trip airfare, applicable taxes, ground transportation, program fee, most meals, local historical site fees, day excursions, youth hostels (where applicable), exchange insurance, and orientation materials.

Deposit: A $300 non-refundable deposit is due upon acceptance Wednesday, December 1, 2010. Final balance is due 45 days prior to departure.

Accommodations: Provided by host families and 1-2 nights in youth hostels in Frankfurt, Tokyo, and Johannesburg.

Scholarships:

A) Limited partial scholarships are available based on financial need. An application will be mailed if indicated on the form. Applications must be submitted before the interview.

B) Yamagata Emerging Leader Scholarship - Based on demonstrated leadership and community service, full scholarship (up to $2,000) available for program of choice. Refer to details in brochure.

Exchanges: Dates: Cost:

Reggio Emilia & Florence, Italy March 12-20 $1,830 Toluca, México March 12-20 $1,185 Trier & Frankfurt, Germany March 12-20 $1,830 Nagaoka & Tokyo, Japan June 8-22 $2,190 Nagaoka, Japan - Harashin Scholar July 25-Aug. 4 $300* Mbabane, Swaziland & Johannesburg, South Africa June 15-30 $3,290

All dates and costs shown are approximations. Costs are based upon a minimum number of students traveling. Side excursions are subject to change. * Not covered by scholarship.

Application and Interview Process: To qualify as a Youth Ambassador, complete the application signed by your parent or legal guardian and submits it with designated items by Wednesday, October 20, 2010. Upon receipt of application, Sister Cities will contact you via letter or phone to schedule your assigned interview and confirm location for interview. You must be accompanied by at least one parent or legal guardian at the interview. Letters of acceptance will be mailed the following week. Invitation to Participate: Applicants invited as Youth Ambassadors for all spring and summer exchanges must attend a pre-travel orientation on Sunday, December 5th from 2-4 p.m. Youth Ambassadors must be accompanied by at least one parent or guardian. Students will meet fellow Ambassadors and receive details to prepare for their exchange.  

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YOUTH AMBASSADOR EXCHANGE APPLICATION 2011

Application Deadline: Received by 4 p.m. Wednesday, October 20, 2010

(PLEASE PRINT CLEARLY)

Name ____________________________________________________ DOB ______________________

School __________________________________________________ Grade Level __________________

HS Graduation Year _____________ Email _________________________________________________

Parent(s) Name ________________________________________________________________________

Address___________________________________ City___________________ Zip Code: ___________

Home/Cell Phone: __________________________ Parent work/cell ph: ___________________________

Parent Email: _________________________________________________________________________

Indicate in numerical order the preference of the countries you would like to be considered for as a Youth Ambassador. Due to limited space, students may be selected for second or third preferences. ____Reggio Emilia, Italy (9-12) ____Nagaoka, Japan (8-12) ____Mbabane, Swaziland (9-12) ____Nagaoka Harashin Scholars Reciprocal Exchange: (9-11) ____Toluca, Mexico (8-12) ____Trier, Germany (9-12)

*In July our family can accommodate a ____ Male ____ Female ____ either (details will be given in interview) Limited partial scholarships are available based upon financial need. I would like to request scholarship assistance in the amount of $_______________. Scholarship application will be mailed. Student Signature____________________________________________ Date______________________ Parent Signature _____________________________________________ Date______________________ Upon completion of your application, attach the items listed below and fax, hand deliver or mail by October 20, 2010 to the address listed below.

• $25 student membership fee. Check or money order made payable to Fort Worth Sister Cities • Copy of last report card • Essay on “What would you contribute to a student exchange experience?”

—one page typed, double spaced. • Yamagata Emerging Leader Applicants: Resume and second essay noted in brochure (one page

typed, double-spaced for both essays) • Recommendation form completed by two teachers, faxed or emailed separately from application.

Fort Worth Sister Cities International • 610 Grove St., Fort Worth, TX 76102

Phone: 817.632.7100 • Fax: 817.632.7120 irene@fwsistercities.org • www.fwsistercities.org

TEACHER RECOMMENDATION FORM

The 2011 Fort Worth Youth Ambassador Exchange Program enables students to visit one of our sister cities in Italy, Germany, Japan, Swaziland or Mexico to experience the history, language, culture and arts of the country they visit. The student will also live with a host family during the exchange period. The student requesting this recommendation from you is in the process of applying to become a Youth Ambassador. Your confidential evaluation of this student is greatly appreciated. Recommendation forms need to be received by Wednesday, October 20, 2010 at 4 p.m. Forms can be mailed or faxed directly to the address listed below. Student Name _________________________________________________________________________ Subject(s) taught this student______________________________________________________________ Teacher’s Name _______________________________________________________________________ Email Address ________________________________________________________________________ School Name _________________________________________________________________________ Rating Scale: 1) Unacceptable 2) Needs Improvement 3) Acceptable 4) Commendable 5) Superior

Evaluated Area Rating Evaluated Area Rating

Maturity ______ Interest in Cultural Diversity ______

Flexibility ______ Sensitive to others ______

Team Player ______ Communication Skills ______

Open- mindedness ______ Respect for authority ______

Please briefly explain why you would/would not recommend this student be accepted to participate in an exchange. Comments will remain confidential.

Fort Worth Sister Cities International • 610 Grove St., Fort Worth, TX 76102 Phone: 817.632.7100 • Fax: 817.632.7120

irene@fwsistercities.org • www.fwsistercities.org

TEACHER RECOMMENDATION FORM

The 2011 Fort Worth Youth Ambassador Exchange Program enables students to visit one of our sister cities in Italy, Germany, Japan, Swaziland or Mexico to experience the history, language, culture and arts of the country they visit. The student will also live with a host family during the exchange period. The student requesting this recommendation from you is in the process of applying to become a Youth Ambassador. Your confidential evaluation of this student is greatly appreciated. Recommendation forms need to be received by Wednesday, October 20, 2010 at 4 p.m. Forms can be mailed or faxed directly to the address listed below. Student Name _________________________________________________________________________ Subject(s) taught this student______________________________________________________________ Teacher’s Name _______________________________________________________________________ Email Address ________________________________________________________________________ School Name _________________________________________________________________________ Rating Scale: 1) Unacceptable 2) Needs Improvement 3) Acceptable 4) Commendable 5) Superior

Evaluated Area Rating Evaluated Area Rating

Maturity ______ Interest in Cultural Diversity ______

Flexibility ______ Sensitive to others ______

Team Player ______ Communication Skills ______

Open- mindedness ______ Respect for authority ______

Please briefly explain why you would/would not recommend this student be accepted to participate in an exchange. Comments will remain confidential.

Fort Worth Sister Cities International • 610 Grove St., Fort Worth, TX 76102 Phone: 817.632.7100 • Fax: 817.632.7120

irene@fwsistercities.org • www.fwsistercities.org