www.aiepusa.com ? firstname.lastname@example.org Phone: +1 (203) 992-AIEP ? 51 Depot Street, Suite #211, Watertown, CT 06795 U.S.A.
Student & Parent Agreement
Student & Paren
AIEP FAMILY ROLE
AIEP’s Homestay Program is comprised of Host Families who truly understand the mission of our program. AIEP’s Host Families support the cultural development of our students, assist in furthering academic development during their academic journey in the U.S., and provide a quality “family” atmosphere that nurtures the whole student, not just the mind. AIEP’s Host Families recognize the value of sharing their lives with children from around the world. This extremely important parental role helps students understand the challenges that they will be faced with living in the U.S., teach them independence, and instill the essential values they will require to succeed in the American education system.
AIEP Students are from various countries around the world. Their desires are to experience the American culture, immerse into American society, and accomplish their goals of attending top universities after graduating from high school. Most AIEP Students attend American high schools, grades 9-12, but there are some children who will start their American education as young as the 7th and 8th grade. AIEP’s Homestay Program recognizes that children need proper guidance as they embark on their journey through the American education system. AIEP’s professional staff and Host Families will all work together to teach students how to appreciate and respect freedom, embrace personal responsibility and make good choices while on their path to success.
AIEP STUDENT & PARENT RECIPE FOR SUCCESS
AIEP Homestay Program is comprised of professional staff members who have been working with children and families in the education field for many years. Experience and collaborative efforts are essential ingredients for the proven success of this program. AIEP’s staff helps Host Families develop confidence in the hosting experience as well as understand the prospective student’s needs prior to their arrival in the U.S. AIEP cooperates with current Host Families, local schools, churches, community centers and other resources to help develop families within the same scholastic and demographic communities. Creating a sense of community is crucial when students wish to attend sporting events, participate in scholastic activities, or share their time with other AIEP students or their American friends. Below are some of the essential tips that every AIEP Student should follow if they are to ensure a successful stay in the U.S.: 1. Participate in the host family environment, understand your hosts are welcoming you to their family and are hosting you out of the goodness of their hearts. Living in Connecticut is very expensive, and the monthly stipend paid to Host Families is usually just enough to cover the basic expenses of hosting a student like yourself – so please be respectful, understanding and grateful for this. 2. Be open to the American culture by participating in everyday events in the host family’s home – be involved and active. 3. Share customs and stories from your home culture, as this will help both you and your Host Family grow a bond with each other. 4. Understand that activities like eating dinner together daily and attending family events are very important parts of being part of an American family. 5. If there are other children in your Host Family’s home, join them when they invite you to go out with friends or attend various events. Spending time with your Host Family will make you feel more comfortable in your new home and in the U.S. 2|Page
6. Explore the history of the local area through day trips, family gatherings and other fun events that your Host Family participates in. 7. Share your excitement in your scholastic progress as well as your interest in extra-curricular activities with your school, classmates, teacher, friend, and Host Family. 8. Help build a strong support system in the AIEP organization, your local school and local community. Remember that you are an ambassador for your country, and that everything you do in the U.S. is a reflection of not only yourself but of the country that you come from.
AIEP ACADEMIC TRAINING PROGRAM
All AIEP Students (a) studying in the U.S. for the first time, (b) student’s whose English skills are not deemed up to par by the school or AIEP during the student’s initial SKYPE interview, (c) OR at the student’s parent’s special request ARE required to enroll in AIEP’s Academic Training Program. The program is 9 weeks long and includes the student being matched with a professional, private tutor that will meet with the student at their Host Family’s household 2X a week, 2 hours per session, for 9 weeks in total. The cost of the Academic Training Program is $___________ and is expected to be paid in full prior to the student’s arrival in the U.S. All of AIEP’s Academic Trainers hold a Bachelors Degree from reputable American university/college, most hold teaching degrees, and some are ELL/ESL certified and/or hold a Masters Degree or above.
Student & Parent Agreement
AIEP STUDENT APPLICATION
Last/Surname: ____________________________ First/Given Name:______________ Middle/Other: _____ Email Address Student: _________________________ Date of Birth: Passport Number: ____________________________ Nationality: ________________ Gender: __________ _______________________ Expiration Date: ________ Country of Issue: ________
PARENTS - PLEASE ANSWER THESE QUESTIONS HONESTLY & ACCURATELY BY YOUR CHILD TO ENSURE THAT THE MOST COMPLETE MEDICAL HISTORY IS PROVIDED WHILE THEY ARE UNDER AIEP’S CARE! Do you take any medications, vitamins, or herbal medications? ___ Yes ___ No How often?______ If yes, explain: Name:_______________ (circle one) Prescription Vitamin Herb If yes, explain: Name:_______________ (circle one) Prescription Vitamin Herb If yes, explain: Name:_______________ (circle one) Prescription Vitamin Herb Please attach additional sheet(s) if additional medications, vitamins, or herbs are taken. Do you have any allergies?____ Yes ____ No If yes, please explain__________________________________ Do you have any special dietary requirements? ___ No ___ Yes If yes, please explain ____________________ Do you suffer from any chronic illnesses? ___ No _____ Yes If yes, please explain:_______________________ Do you smoke? ___ No ____ Yes How much per day? _____ How long have you smoked?__________ Do your parents smoke? ___ No ___ Yes Would host parents who smoke bother you? No ___ Yes Do you like animals? ___ No____ Yes Do you have any animals? ____ No ___ Yes Do you have allergies to pets? ____ No ____ Yes Do you like young children? ____ No ____Yes Could you adjust to a home that has young children? ___ No ____ Yes
Student & Parent Agreement
AIEP PROGRAM & HOSTING
I/We, the undersigned parent(s)/legal guardian(s) of the student under the care of AIEP, agree to provide full financial, disciplinary and academic support for our child to ensure his/her success while actively involved in the AIEP’s Homestay Program. In return, AIEP is expected to provide our child with an appropriate academic support, programs and host family environment, as stipulated by the laws and regulations of the United States, for the duration of our child’s education in America.
1) Host Family Placement AIEP Fees:
Homestay Program Fees are imperative to the proper support and care of your child while living in America. Depending on the State and city/town where your child will attend school, the fee will vary. A portion of the Homestay Program Fees will be held in an escrow account and disbursed once a month in the form of a stipend to the Host Family to ensure your child will be financially cared for while living in America. All fees are payable IN ADVANCE, prior to the student’s arrival in America. Students will not be allowed to arrive in the U.S. or stay in a host family until all fees have been received in America by AIEP - these fees will be nonrefundable once paid and a Visa is obtained the student. Unless your child does NOT receive a Visa, the program deposit fee is also non-refundable. If your child does not receive a Visa, then and only then will the program deposit will be refunded. Homestay Program Fees include the following: 1. Host Family Selection & Matching Process – initial screenings of interested families via phone calls, inperson house visit by Local Homestay Coordinator (including family interview and taking photos of potential student’s bedroom and common area), criminal/civil/national sex offender background checks, reference calls to 2 non-family members, complete Host Family Profile with photos prepared for student and natural parents prior to student’s arrival in the U.S. 2. Supportive and Professional Staff for your child’s care and support while studying in America, including but not limited to Program Directors, Team Leaders, Academic Director, Academic Advisors & Local Homestay Coordinators. 3. General Academic Support Staff to monitor and report on your child’s progress in his/her U.S. high school. Monthly check-ins of your child’s academic progress and formal, written Quarterly Academic reports will be provided to you by AIEP. 4. Meals: Monday thru Friday, breakfast and dinner to be provided by Host Family; lunch will be offered at school on school days. The student is responsible for using his or her own money to purchase lunch at school. Saturday and Sunday, breakfast, lunch and dinner to be provided by Host Family. The student is expected to eat the same meals and food as the Host Family, primarily Western-style food served to the other members of the family. 5. Resources necessary to help monitor your child’s Host Family during his/her stay in America, including monthly Conference Calls with Host Families, periodic Host Family visits by Local Homestay Coordinators, and Student & Host Family Orientation to be held in the beginning of the school year. 6. Full-time staff to monitor phone and e-mail correspondence from local Host Families, AIEP students and international families and agencies. 7. Disciplinary Committee, if necessary (i.e.: assist with host parents in setting up curfews, study plans, remedial disciplinary measures, limiting internet/T.V. usage, etc.) 8. Formal Quarterly Host Family Reports on child’s social and academic progress, unless other challenges arise and more frequent communication is necessary 5|Page
9. Assistance with integrating your child into mainstream American society [community service events, volunteer opportunities, fun day and weekend excursions (at extra cost to student), intramural sporting events, etc.]
As a guest member of the Host Family, all students are expected to take the responsibility of keeping his or her own bedroom clean and neat, and cleaning up after him or herself in the bathroom. The student is also expected, if asked by the Host Family, to assist with reasonable household chores (i.e. clearing/setting the table, taking out the trash, etc.) in a manner equal to that which is expected of other children living in the Host Family’s house.
All students are expected to respect the in loco parentis authority of the host parents, who will explain to the student from the beginning of the hosting experience clear and reasonable rules according to the norms typically employed by American parents of American teenagers. It is the student’s responsibility to inform the Host Parent at all times of his or her whereabouts, to obey curfew requirements, and to ask the host parents’ permission in advance to participate in activities outside of the household. All Host Families will prepare a formal, written agreement outlining what is expected of their student. This document will be reviewed by the student during AIEP’s Orientation and must be signed by the student. Student must abide by all rules and expectations as outlined in the Host Family Agreement – no exceptions.
It is the student’s ultimate responsibility to communicate honestly and respectfully with the Host Parents at all times, and to take the initiative in bringing to the Host Parents’ prompt attention any issues or problems that arise. If a problem cannot be resolved through direct communication between the student and the Host Parents, the student should bring his or her concerns to the attention of their school and/or AIEP officials for mediation and intervention.
2) Physical Exam and Proof of Immunization Requirements
All students attending American schools are required to meet certain health requirements as set by Federal, State and local laws. Some States require students to undergo annual physical examinations conducted only in the U.S., in which case the Host Parents & AIEP Staff can help arrange appointments to do so. All students are required to present proof of immunizations to AIEP PRIOR to their departure from China, without which they will not be permitted to enter school. Students should receive all required immunizations, as specified by their school, before departing from China. Most U.S. States require the following – please check with AIEP for specifics before receiving these specific vaccinations: Hepatitis B (3 doses) DTaP/DTP/DT/Td/Tdap (4 doses or 3 doses of Td and 1 dose of Tdap) Polio (3 or more doses) MMR (2 doses) Varicella (2 doses) TB test (if the student is from a country deemed to be TB-endemic including China)
The following should be completed after departing China, and only to be completed in the U.S.:
During the academic year, permission to travel to another country cannot be granted from AIEP without a) a letter from the student’s natural family giving the student permission to travel to a specific country; and b) a letter of invitation from the family or organization (if other than the Host Family) that will be hosting the AIEP Student; and c) the signature of approval of the designated school official on the student’s I-20 form. Without this signature, the student might not be allowed to re-enter the U.S. or may be fined upon re-entry. In addition, the student should consult an official in the consulate of the country to which she/he plans to travel to—requirements vary, both by country of destination and by country of citizenship. The student should allow plenty of time to have all of this completed, as the process can take a month. Any student wishing to travel outside of the U.S. should seek AIEP approval before booking any transportation of any kind. It is generally recommended that students not travel outside of the U.S. while under AIEP’s care (except returning to a student’s native country) due to the complicated nature of visa requirements, etc. Students wishing to travel within the U.S. during the course of their stay but without the accompaniment of their Host Parents are required to submit in advance a request for Permission to Travel Form (enclosed), signed by their natural parents. The students should be accompanied by an adult over 21 years old at all times – no exceptions. AIEP may arrange adult supervision for students for trips outside the city (during the holidays) and the students and parents will cover the cost of the supervisors.
4) Use of Motor Vehicles/Driver’s Education Course
AIEP students are forbidden to drive a car, boat, motorcycle, all-terrain vehicle, or any similar vehicle while they are in the United States, including the period before or after the official school year. Equally important, AIEP students may not enroll in a Driver’s Education course in the U.S., since such courses have as an integral part of the curriculum the practice of driving a car and this is not allowed.
5) Dress Code
It is the student’s responsibility to familiarize him or herself with school dress code requirements before arriving in the U.S., and to ensure they will have appropriate attire in time for the first day of school. Students are responsible for paying for their own uniforms and other clothing purchases. Please contact AIEP if you are unsure of your school’s specific dress code requirements.
6) Personal Finances
Students should arrive in the U.S. with an internationally accepted credit card and/or a reasonable amount of cash sufficient to cover personal and school expenses during the first few weeks. AIEP will set up student checking accounts with ATM cards that will be monitored by AIEP’s staff for sufficient funds and irregular purchases. AIEP will provide students and their natural parents with the student’s wire instructions for wiring money from abroad. While Host Families are expected to cover the cost of normal school transportation and food (except for school busing, school lunches, school trips, etc. which are the student’s responsibility), students are expected to pay for the following: - personal items such as shampoo, toothpaste, etc. - textbooks, school supplies, and school uniforms - clothing - personal entertainment expenses - long-distance outings arranged by AIEP (day and weekend trips) - travel expenses (hotel, flights, car transportation, meals while on vacations with/without Host Family) - computer and phone purchases and cell phone data plans (students are expected to establish their own phone accounts under their own names) 7|Page
any medical expenses not covered by the AIEP-designated insurance plan and/or co-pays as required by medical facility/professional
7) Health insurance and Permission to Treat in a Medical Emergency
Every international student is required to be covered by health insurance before arriving in the U.S. AIEP will help purchase an appropriate health insurance policy for the student. The student and student's biological parents must sign an AIEP Parental Consent Form (please contact AIEP for this specific form), which will give AIEP and the Host Family the authority to request treatment for the student as needed.
AIEP works with the school to prepare international students for their American high school experience. Students are required to arrive before the start of school and to attend an AIEP Orientation program with their Host Parents, which usually takes place 2 weeks prior to the first day of school. All students must be present in the U.S. to attend this Orientation, so please book your flight to the U.S. early and on-time – do not wait until the last minute.
9) Program Fee
It is understood that a student’s placement with an AIEP Host Family is for the entire academic year (10 months). Fees shall be payable for the entire academic year (10 months) to which this Agreement applies notwithstanding the fact that the Student ceases to reside in the placement for any reason. No part of the Program Fees paid to AIEP after a student has received their Visa will be refunded due to withdrawal from the program during the academic year – no exceptions.
10) Continuity with AIEP and the School
AIEP has invested a lot of time and resources into building long-term partnerships with their partner schools to enable international students to enroll, study in the U.S., receive a high school diploma, and ultimately graduate. I/We agree that AIEP’s partnership with the school stipulates that as long as I/we enroll at the school, I/we will stay with AIEP and not transfer to another homestay organization or agency.
SECTION TO BE COMPLETED BY THE STUDENT:
I acknowledge as a student enrolling in AIEP’s Homestay Program that I understand and agree to abide by the rules, policies, and expectations as described above in their entirety. I acknowledge that failure to abide by these rules, policies, and expectations could result in my being asked to leave the program without being entitled to a refund of any kind. ___________________________________ Full Name (TYPED) of Student ____________________________________ _______________________________ Signature of Student Today’s Date
SECTION TO BE COMPLETED BY THE PARENT(S):
I/We acknowledge as the parent(s)/legal guardian(s) of the above named student that I/we understand the rules required in order for my child to be a participating member of the school and will join my child in following these rules. I/We acknowledge that my child’s failure to abide by these rules, policies, and expectations could result in my child being asked to leave the program without being entitled to any refund of any kind. ___________________________________ Full Name (TYPED) of 1st Parent / Legal Guardian ____________________________________ Signature of 1st Parent/Legal Guardian ________________________________ Today’s Date
___________________________________ Full Name (TYPED) of 2nd Parent / Legal Guardian ____________________________________ Signature of 2nd Parent/Legal Guardian ________________________________ Today’s Date
Homestay P ROGRAM & F EES A GREEMENT
I/We, the undersigned parent(s)/legal guardian(s), agree to the payment terms (see attached) of this application for our child and agree that Apex International Education Partners, LLC (AIEP) has the right to terminate this agreement should any of the policies of AIEP be violated by the parent(s)/legal guardian(s) and/or the child. I/We agree that if for any reason, prior to the issuance of an I-20, I/we wish to rescind this application, the Program Deposit will be forfeited. Payment is due, in full, prior to my child’s arrival in America for AIEP’s Homestay Program and understand that failure to pay all fees in full prior to my/our child’s arrival in America will result in immediate termination of his/her I-20 and acceptance to the school will be rescinded. I/We further agree that it is my/our responsibility to work with AIEP to ensure the best academic and immersion experience for my/our child. Failure to do so can result in immediate expulsion from the AIEP program, regardless of my/our child’s academic performance in school. We understand that these regulations are set forth to maintain the highest standard and integrity of the AIEP’s Homestay Program for all participating students. As such, I/we agree to the terms of the full AIEP Homestay Program and Academic Training program package and financial obligations. I/We agree to uphold our full financial obligations for my/our child throughout his/her entire stay in the AIEP Homestay Program. I/We understand that if our child does not pass the visa interview that this contract will be void and I/we will receive all payments made. I/We understand that all fees paid to AIEP after Visa interview approval (including initial deposit) are nonrefundable, and will not reimbursed in any way or form. I/We further understand that AIEP shall have the unrestricted right to assign this agreement in whole or in part to, and to cause all or any portion of the services to be performed by, any affiliate (any person that directly or indirectly controls or is controlled by or is under common control or ownership with AIEP) and/or third party (each, a “subcontractor”) at AIEP’s sole and exclusive discretion and cost. It is further understood that all program fees are subject to change annually (roughly 5%-10%). ______________________________ Signature of Father/Legal Guardian ______________________________ Signature of Mother/Legal Guardian ______________________________ Signature of AIEP Representative _________________________________ Printed Name of Father/Legal Guardian _________________________________ Printed Name of Mother/Legal Guardian _________________________________ Printed Name of AIEP Representative ______________ MM/DD/YYYY ______________ MM/DD/YYYY ______________ MM/DD/YYYY
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AIEP Parental Consent Form
In case of illness, accident or injury of my/our child, I/we, the undersigned, grant permission to AIEP Representatives, subcontractors, the Host Family, and/or the authorized guardian during my/our child’s travel, to seek treatment by qualified medical personnel if/when necessary. I/We also grant AIEP Representatives, Subcontractors, the Host Family, and/or the authorized legal guardian during my/our child’s travel, permissions to act as legal guardians, especially in emergencies, whether medical or other services, including x-rays, MRIs, EKGs, ultrasounds, lab tests, immunizations, surgical operations or any other medical treatment. This authorization also grants permission to release information regarding my/our child in order to receive any and all inoculations or immunizations required by Federal, State and local authorities, for participation in the AIEP’s Homestay Program. I/We also hereby authorize that a photocopy of this authorization be accepted with the same authority as this original. AIEP is expected to provide our child with appropriate care as stipulated by the laws of the United States. I/We, the undersigned release AIEP Representatives, subcontractors, the Host Family, and/or the authorized legal guardian during my/our child’s travel, from any and all current and future claims, charges, costs and/or causes of action for loss of property, personal injury, illness, accident or death sustained by my/our child during the time that he/she is a participant in the AIEP Homestay Program, regardless of insurance coverage. I/We further agree to indemnify all of the above named entities from any and all liabilities, including liabilities to third parties, and accept full financial and legal responsibility for my/our child. I/We certify that all information, inclusive of medical and immunization history, provided in the application is correct and complete. I/We understand that withholding information and/or providing incorrect information is grounds for possible termination from the AIEP Homestay Program, and my/our child will be returned home to his/her country at the my/our full expense, and all AIEP program fees will be forfeited. I/We further understand and consent that AIEP may use any film likeness taken of my/our child and any quotes made by my/our child while participating the AIEP Homestay Program in any promotional materials, and that the publication and distribution of these materials may extend for several years beyond this date. I/We certify that I/we have purchased student accident/travel insurance for the duration of his/her study abroad program and provide the insurance information/policy number as follows _______________________________________________ and have submitted a copy of the insurance policy to the agency and AIEP with my/our child’s immunization records PRIOR to my/our child’s arrival in the U.S. This Guardianship Proxy shall be valid from (mm/dd/yyyy) ___/____/_____and ending (mm/dd/yyyy) ___/____/______. This Guardianship Proxy for my child ____________________________ must be renewed each year/semester he/she is a participant in the AIEP Homestay Program.
______________________________ Signature of Father / Legal Guardian ______________________________ Signature of Mother / Legal Guardian ______________________________ Signature of AIEP Director/Agent
__________________________________ Printed Name of Father / Legal Guardian __________________________________ Printed Name of Mother / Legal Guardian __________________________________ Printed Name of AIEP Director/Agent
_____________ MM/DD/YYYY _____________ MM/DD/YYYY _____________ MM/DD/YYYY
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Student & Parent Agreement AIEP C ONTACT I NFORMATION David Guerrera Office #: 203-992-AIEP Email: info@AIEPUSA.com
Parental Documents that must be reviewed, signed, and returned:
? ? ? ? ? Parent(s) to Fill Out Page 4 Child to Fill In & Sign Bottom of Page 8 - Student & Parent Agreement Parent(s) to Fill In and Sign Page 9 – Student & Parent Agreement Parent(s) to Fill In & Sign Page 10 – Homestay Program & Fees Agreement Parent(s) to Review & Sign Page 11 – AIEP Parental Consent Form
Special Notes for Parent(s) and Student:
It is highly important that you read, review, and understand the above/attached documents for the AIEP Homestay and Academic Training Program. These regulations are governed under Federal, State and local U.S. laws and are bound by these laws. Falsifying documents, or failure to comply with the regulations set forth in this document will be cause for immediate termination of your child’s application and it will be withdrawn from any and all schools. Furthermore, the I-20 for entry to the U.S. will be revoked or not be issued. Any attempt to gain entry to America on falsified documents will and must be immediately reported to SEVIS. Full disclosure of medical, academic and social records are expected upon initial application. Thank you for your interest and continued support of the AIEP Homestay & Academic Training Program!
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