General Information
Student Name ____________
Date ____________
Host School ____________
Local Coordinator ____________
How is your overall cultural adjustment in China?
Cultural adjustment ★ ★ ★ ★ ★
If there is anything you feel confused or difficult about culture, please share with us.
How is your Chinese language progress?
Language progress ★ ★ ★ ★ ★
If there is anything you feel difficult and need further support about Chinese study, please share with us.
How is your high school class going?
High school class ★ ★ ★ ★ ★
If there is anything you feel difficult and need further support about high school class, please share with us.
How is your life with hostfamily?
If there is anything you feel confused or need guidance in your family, please share with us.
How is your overall wellbeing?
If you don't feel well, please let your hostparent know immediately. Please report local coordinator Mr. Ji within 24 hours of going to a hospital because we need to report that to the State Department, even if it doesn't seem very serious. Is there any further support needed?
Would you like to share with something we haven‘t talked about yet?
Any other comment from school, family and contact person?