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pdfU.S. DEPARTMENT OF STATE
FLEX HOST FAMILY SURVEY
INTRODUCTION
On behalf of the U.S. Department of State’s Bureau of Educational and Cultural Affairs (ECA), Youth Programs
Division, we are requesting your participation in a survey to determine the impact that hosting Future Leaders
Exchange (FLEX) students has on U.S. host families.
This survey will cover the following topics:
Your Host Family Involvement with the FLEX Program
Involvement of Your Family, Friends & Colleagues
Your Personal Relationships with FLEX Exchange Students
General Information About You and Your Family
CONFIDENTIALITY
The U.S. Department of State will protect the privacy of individuals who participate in this voluntary survey. All of
your responses to this survey will be combined with those of other respondents, and the answers you give will be
strictly confidential and will not be identified as your responses.
SURVEY INFORMATION [PAPER VERSION ONLY]
Please return your completed survey in the enclosed self-addressed stamped envelope to: U.S. Department of
State; Office of Policy & Evaluation (ECA/P/V); 301 4th Street, SW, Room 336; Washington, D.C. 20547
Or, you can complete the survey via Internet at the following website: [TBD]
Note: If you are disconnected from the website, simply login again and you will automatically return to the part of
the survey where you stopped completing questions.
Your return ID number for the web survey is: __ __ __ __ __ __
QUESTIONS
If you have any questions, please feel free to contact:
Eric M. Brooks
Evaluation Coordinator
Office of Policy & Evaluation
Telephone Number: 202.453.8820
Fax Number: 202.453.8821
E-mail: [email protected]
PRIVACY ACT AND PAPERWORK REDUCTION ACT STATEMENTS
The information solicited on this survey is requested pursuant to the Government Performance and Results Act of 1993 (P.L. 103-62) and the Mutual
Educational and Cultural Exchange Act of 1961, as amended, also known as the Fulbright-Hays Act (22 U.S.C. 2451, et seq.). In order to ensure that the U.S.
Department of State’s international exchange programs meet statutory program requirements (22 U.S.C. 2460(c)), the Department’s Bureau of Educational
and Cultural Affairs (ECA) regularly monitors the programs, gathers data about program accomplishments, and evaluates selected ones. ECA uses the
information collected to inform program design, management, and funding. All personal information that is collected through surveys is considered confidential.
All responses are coded to ensure the confidentiality of individual responses. Data collected under this study will not be shared, sold, or used for fundraising
purposes. Survey data and findings will be used only in an aggregate form for the express purposes of fulfilling the data needs of the outcome assessment.
Responses to this survey are voluntary. Public reporting burden for this collection of information is estimated to average thirty (35) minutes to respond to this
survey, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing
the collection of information. An Agency may not conduct or sponsor, and respondents are not required to respond to, a collection of information unless it
displays a valid OMB control number. Please send comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing the burden, to: A/IIS/DIR, U.S. Department of State, Washington, D.C. 20520.
FLEX Host Family Survey
Host Family Involvement with FLEX Program
1.
2.
3.
What ID number were you assigned in the letter you
received from the U.S. Department of State?
How many FLEX exchange students have you hosted
in your home? [dropdown]
1994 – 1995
1995 – 1996
1996 – 1997
1997 – 1998
1998 – 1999
1999 – 2000
Host Family
Local FLEX Coordinator
Exchange Agency Representative
Other FLEX Program Volunteer
Other, Please Specify:
2000 – 2001
2001 – 2002
2002 – 2003
2003 – 2004
2004 – 2005
2005 – 2006
2006 – 2007
7.
8.
What was the home country or countries of the FLEX
exchange student(s) you hosted? Please check all that
apply.
Armenia
Azerbaijan
Belarus
Georgia
Kazakhstan
Kyrgyzstan
Moldova
Russia
Tajikistan
Turkmenistan
Ukraine
Uzbekistan
Do Not Know
5.
In what capacity have you been involved with the
FLEX Program? Please check all that apply.
In what academic year(s) did you host a FLEX
exchange student(s)? Please check all that apply.
1993 – 1994
4.
6.
Have you been involved, as a host family with any
other high school student exchange program(s)?
No
If NO, please go to Question [#]
Yes
If YES, please go to Question [#].
Of the following other high school student exchange
programs, for which have you been a host family?
Open World
People to People
Sister Cities Exchange
Youth for Understanding
Rotary International Exchange
Youth Exchange and Study (YES) Program
Congress-Bundestag Youth Exchange (CBYX)
Other, Please Specify:
How did you learn about the FLEX Program?
Please check all that apply.
Business Colleague
Community Member
Direct Contact with Exchange Agency
Exchange Agency Website
Family Member
Friend
Local Community Center
Local FLEX Coordinator
Local High School
Newspaper Article/Advertisement
U.S. Department of State Website
Other, Please Specify:
Do Not Know
OMB No:
Expiration Date:
Estimated Burden Time: 35 minutes
Not Sure
9.
How many non-FLEX exchange students have you
hosted in your home? [dropdown]
1
10.
The following are possible reasons for volunteering with the FLEX program. Please indicate how important each of these
reasons is to you for hosting FLEX exchange students. Please check one box in each row. Check N/A, if the statement is not
applicable.
Very
Important
Moderately
Important
Slightly
Important
Not At All
Important
N/A
I feel hosting foreign exchange students contributes to my children’s
education
I feel an obligation to share hospitality received in other countries
I want to meet people from around the world
I want to share my community with foreign exchange students
I want to learn more about foreign countries and cultures
I want to help improve the overall image of the United States
I want to continue the legacy of hosting foreign exchange students
instilled by my parents or other family member(s)
Other, Please Specify:_______________________
I feel it is important for foreign exchange students to meet “real
Americans”
I feel that hosting foreign exchange students broadens my family’s
perspective
11.
Please describe some of the benefits to you and your
family in hosting FLEX exchange students.
13.
How often did you discuss the following topics with your most recent FLEX exchange student considering the student’s home
country? Please check one box in each row.
Daily Life
Economy
Educational System
Ethnic Diversity
Legal System
Media/Press
Political System
. Religious Diversity
Values and Culture
Voluntary Community Service
OMB No:
Expiration Date:
Estimated Burden Time: 35 minutes
12.
Please describe some of the challenges to you and
your family in hosting FLEX exchange students.
Very Often
Regularly
Sometimes
Rarely
Never
Do Not
Know
2
14.
How often did you discuss the following topics with the most recent FLEX exchange student considering the United States?
Please check one box in each row.
Daily Life
Economy
Educational System
Ethnic Diversity
Legal System
Media/Press
Political System
. Religious Diversity
Values and Culture
Voluntary Community Service
15.
Regularly
Sometimes
Once or Twice
Never
Do Not
Know
Thinking about your most memorable FLEX exchange student, what was your level of knowledge about the following
aspects of the student’s home country BEFORE learning that you would be hosting the student? Please check one box in each
row.
No Knowledge
Limited
Moderate
Extensive
Do Not Know
At All
Knowledge
Knowledge
Knowledge
Daily Life
Economy
Educational System
Ethnic Diversity
Legal System
Media/Press
Political System
Religious Diversity
Values and Culture
Voluntary Community Service
16.
Very Often
Thinking about your most memorable FLEX exchange student, what was your level of knowledge about the following
aspects of the student’s home country AFTER hosting the student? Please check one box in each row.
Daily Life
Economy
Educational System
Ethnic Diversity
Legal System
Media/Press
Political System
Religious Diversity
Values and Culture
Voluntary Community Service
OMB No:
Expiration Date:
Estimated Burden Time: 35 minutes
No Knowledge
At All
Limited
Knowledge
Moderate
Knowledge
Extensive
Knowledge
Do Not Know
3
17.
What makes this particular FLEX student the most memorable?
18.
Please indicate the extent to which you agree or disagree with whether hosting FLEX exchange students…
Neither
Strongly
Agree nor
Agree
Agree
Disagree
Disagree
Promotes mutual understanding among Americans and
people from other countries
Promotes peaceful relations between the United States
and other countries
Promotes United States national interests
Helps my family and me develop friendships with
people from other countries
Helps my family and me better appreciate people
from other countries
Helps my family and me improve our foreign
language skills
Increases my family’s and my interest in international
events and news
Increases my family’s and my interest in visiting
foreign countries
Helps my family and me learn more about the
perspectives of people from other countries
Helps me educate my children about other countries
and cultures
Gives my family and me the opportunity “to make a
difference”
Allows my family and me to share United States
values and beliefs with people from other countries
Allows my family and me to share my local community
with people from other countries
Allows foreign exchange students to share their values
and beliefs with my family and me
Allows my family and me to volunteer our time and
resources in our community
Offers my family and me an opportunity to return
hospitality that we received in other countries
Increases my family’s and my appreciation of our local
community
Increases my family’s and my appreciation of the
United States
OMB No:
Expiration Date:
Estimated Burden Time: 35 minutes
Strongly
Disagree
N/A
4
22.
Involvement of Your Family, Friends & Colleagues
Have you ever spoken with family, friends and/or
colleagues about your experience(s) hosting FLEX
exchange student(s)?
Yes
No
Whom do you speak with about your hosting
experience? Please check all that apply.
Business Colleague(s)
Community Member(s)
Family Member(s)
Friend(s)
Neighbor(s)
Other(s)
N/A
In general, how often do the following people directly participate in the
hosting experience? Please check one box in each row.
23.
As a result of your hosting a FLEX exchange student,
have any of your extended family, friends, neighbors
and/or colleagues hosted a FLEX exchange student?
Please check all that apply.
Friends
Colleagues
N/A
Never
Regularly
Family
24.
Pursued a career in international relations or
foreign affairs. (e.g., Peace Corps volunteer,
Foreign Service Officer, career with United
Nations, etc.)
Pursued a career in international law (e.g..,
international trade law, human rights law, etc.)
Always
21.
Rarely
20.
Traveled to a foreign country to study (e.g., study
abroad, Semester-At-Sea, U.S. exchange student,
etc.)
Studied a foreign language spoken by a former
FLEX exchange student(s) (e.g., Russian, Ukrainian,
Uzbek, Azerbaijani, Kazakh, Armenian, etc.)
Pursued a college degree in international relations
or international studies (e.g., Bachelors or Masters)
Go to Question [#]
Skip to Question [#]
Sometimes
19.
After the experience of hosting a FLEX student(s), has
your child (or children) done any of the following?
Please check all that apply.
Business Colleague(s)
Community Member(s)
Family Member(s)
Friend(s)
Neighbor(s)
Other(s)
Now, we would like to ask a series of questions about how hosting a FLEX student(s) may have impacted your and your
family’s life. Please indicate the extent to which you agree or disagree with each of the following statements.
After the experience of hosting a FLEX student(s), my family and I are
more likely to:
Strongly
Agree
Neither
Agree nor
Strongly
Agree Disagree Disagree Disagree N/A
Read or listen world news
Read or hear news about the FLEX student’s home country
Learn about the culture/traditions of other countries
Learn more about the culture/traditions of the student’s home country
Attend cultural events from the student’s home country
Volunteer my time with other student exchange programs
Meet people from other countries
Travel to other countries
Learn another language
OMB No:
Expiration Date:
Estimated Burden Time: 35 minutes
5
25.
What motivated you and your family to begin hosting
FLEX exchange students?
30.
How many FLEX exchange students have you
maintained contact with after hosting them in your
home [dropdown]?
None
1 FLEX Student
2 FLEX Students
3 FLEX Students
4 FLEX Students
5+ FLEX Students
26.
What motivates you and your family to continue
hosting FLEX exchange students?
31.
Skip to Question [#]
In general, how frequently do you and your FLEX
exchange student(s) contact one another?
Once a Year
2 to 3 Times a Year
More than 3 Times a Year
Never
Not Sure
32.
27.
Of the FLEX exchange student(s) you have hosted,
have you visited any of them in their home country?
Yes
No
28.
33.
If Yes, please check the country or countries you have
traveled to, in order to visit a FLEX exchange student(s).
Please check all that apply.
Armenia
Azerbaijan
Belarus
Georgia
Kazakhstan
Kyrgyzstan
29.
Go to Question [#]
Skip to Question [#]
Moldova
Russia
Tajikistan
Turkmenistan
Ukraine
Uzbekistan
What topics do you and the FLEX exchange student
discuss during your contact(s)?
Please check all that apply.
Possible/Upcoming Visits
Personal/Family News
New Contact Information
International News/Events
U.S News/Events
Other
34.
If yes, please describe the situation that prompted you
to visit your FLEX exchange student(s) in their country.
Have any FLEX exchange alumni visited you in your
home after their exchange program?
Yes
No
35.
OMB No:
Expiration Date:
Estimated Burden Time: 35 minutes
How do you and your FLEX exchange student(s) stay in
contact with one another? Please check all that apply.
Letters
Telephone Calls
E-mails
Faxes
Personal Visits
Other
Personal Relationships with FLEX Students
Go to Question [#]
Skip to Question [#]
If yes, please describe the situation that prompted the
FLEX alumni to visit you and your family after their
exchange program.
6
Information About You & Your Family
36.
37.
42.
Which category best describes the location of your
home?
Less Than High School Diploma
High School Diploma/GED
Rural/Farm Area
Vocational/Technical Diploma or Certificate
Suburban Area
Some College, No Degree
Small Town or City
Associate’s Degree (AA, AS)
Large or Major City, Not Capital
Bachelor’s Degree (BA, BS)
State’s Capital City
Master’s Degree (MA, MS)
Doctorate Degree (PhD, EdD)
Including yourself, how many people reside in your
household? [dropdown]
Professional Degree (MD, MBA, DDS, JD, LLB)
43.
38.
How many children under the age of 18 years reside
in your household? [dropdown]
39.
Which category best describes your marital status?
Single, Never Married
Living Together, Not Married
Married
Divorced
Separated
What is your age? [dropdown]
18 - 24 Years
25 -34 Years
35 - 44 Years
45 - 54 Years
55 - 64 Years
65 - 74 Years
75 Years or Older
41.
44.
What is your field of work or profession?
Please check all that apply.
Agriculture
Arts & Culture
Business/Finance
Education
Government
Homemaker
International Affairs
Legal/Law Enforcement
Media/Communications
Medicine
Military Service
Non-Profit
Public Administration
Retired
Science & Technology
Trade
Other
Widowed
40.
Which category best describes your highest level of
formal education?
Do you have any suggestions or feedback for the
U.S. Department of State and the exchange agencies
on how to attract new host families to become
involved with the FLEX Program?
What is your gender?
Female
Male
OMB No:
Expiration Date:
Estimated Burden Time: 35 minutes
7
| File Type | application/pdf |
| File Title | Final Survey_ FHF _20070810 |
| Author | esterrichlk |
| File Modified | 2007-08-10 |
| File Created | 2007-08-10 |