Quick Reference Sheet

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1 Quick Reference Sheet First Name: Hans Christian Age upon arrival: 16 Gender: Male Home Country: Denmark SUMMARY OF STUDENT S INTERESTS, PERSONALITY, AND HIGH SCHOOL YEAR AMBITIONS Hans is a sweet young man. He is very open-minded, helpful, and positive. He is very excited to live with a host family and improve his English skills. In his sparetime he enjoys doing all kind of sports. He likes to watch football with his family and friends, and he would enjoy football experiences from another country. He also enjoys cooking with his family. He is a social boy. NATURAL FAMILY INFORMATION Student lives with: Both Parents Parent's marital status: Married Mother's occupation: Father's occupation: Self-employed HOME COMMUNITY INFORMATION Community type: City or Town Community population: 10,001-50,000 GENERAL INFORMATION Dietary allergies/restrictions: Additional Info: Pet/dust/hair allergy: Additional Info: Medical issues: Additional Info: Religion: Buddhist Attends services how often: 1-2 times per year Opposed to living with different religion: Attend services with family: Yes Open to single parent: Open to double placement: Yes Pre-Placement: Pre-Placement Info: ACADEMIC SUMMARY Oral Skill in Host Language: 6 Scaled SLEP Score: GPA (home grading system): 8,6 GPA (host grading system): B+ Graduated: Academic tes: Hans is a wounderful student. He works very seriously and is very ambitious. He is also extremely polite and nice. He shows great responsibility in all his work and behaving. He achieves excellent

2 grades. He is very social and is popular among his classmates.

3 Student Information First Name Hans Christian Country of Residence Denmark Gender Male Country of Birth Denmark Country of Citizenship Denmark Family information My parents are I live with my Married Both Parents Program and School Information Destination Country United States Departure September 2014 Length FULL YEAR Have you ever participated in an exchange to the US before and/or received an F- 1 or J-1 visa for entry into the United States for any reason? What grade/level in school will you have completed by the time you travel to your host country? 9. Grade Will you have completed 12 years of schooling by the time you travel to your host country? Will you have graduated from high school by the time you travel to your host country? My community Type City or Town Population 10,001-50,000 Personal Profile

4 Height (cm) 170 Weight (kg) 60 Are you a vegetarian or are there any foods you cannot eat because of health, religious or other reasons? Do you smoke? EF Foundation cannot guarantee a host family of a particular religion. Would this be an issue for you? Would you be willing to attend religious services with your host family? Are you allergic to pets or is there any other reason why you can not live with pets in the home? Yes Activities and Interests Indoor activities Musical activities Outdoor activities Family activities Sports activities Soccer My Favorite Daily Community service What are your favorite activities and why? I really like to watch a football match with my my family and friends. I often play football and it could be nice to get new football experiences from another country. What types of activities would you like to do with your host family? I would like to cook dinner with my family and just have a great time. General Questions Do you have any pets or any favorite animals? Are there any animals you do not like? I'm not a big fan of pets, animals and especially big dogs like pitbull. And we have no pets. Why do you want to spend a year abroad? I really like to improve my english vocalbulary and experince a different culture. Why do you think you will be a successful exchange student? Because I am very ambitious and like learn new things every day. What can you tell us about yourself, your personality or your habits that will help us match you with a host family? I am an honest and open minded boy who loves to sepnd time with my family. I like to learn new things an d experience new things. Please describe any awards you have received or any achievements that you are proud of.

5 I have rechieve good marks from the middle term exam If you had a misunderstanding with your host family, how would you try to resolve it? I would talk to them about it and try to find a good solution, since i'm not a person who like to discuss alot. What are your goals in life? Get a high education so I can achieve something great in the future and become a successfull person. What do you hope to achieve after your exchange? I hope I will be better at English and get a good vocabulary. I would also like to develop as a person and also learn to handle situations on my own. How many hours per day do you spend doing your homework? 2 to 3 hours Which are your favorite subjects at school and why? My favorite subjects is differently Mathematics and Danish because I'm best at these subjects. Do you study any other foreign languages besides English? Second foreign language Third foreign language Yes German Cambodian How many years have you studied English? 3 How much time do you spend on the internet per day and what do you generally use it for? I spend a couple of hours on the internet daily and I use it for communication (Facebook, Skype, Instagram, Snapchat) and homework. Please describe any summer job, after-school job or volunteer position that you have had.... What are your family responsibilities and rules? What chores do you do to help your parents at home? I don't have any rules I just do what is needed like clean the house and take care of my sisters. What language(s) are spoken in your home? Danish and Cambodian Which words would best describe you? Active, Ambitious, Family oriented, Honest, Likeable, Neat, Open minded, Quiet, Shy, Spoiled, Thoughtful Which words would best describe your family's lifestyle? Home-oriented, Independent, Modern, Relaxed, Traditional What do you think you will miss most during your exchange year? How do you think you will react if you get homesick? I will specially miss my family and friends because mean a lot to me. I think I will feel a bit lonely but then I just have to speak with the host family and then I think will feel better.

6 Have you been away from your family for more than a few days before? Yes Please explain I have been in Spain with my class for one week. It haven't affect me at all because I am use to handle my own situation. How will your parents react to your spending a year abroad? Do they support your decision? Yes they support me a lot and they will do everything for me. My parents will worry about me but I have promised that nothing will happen to me. Describe a typical day in your life. I go to school and when i get home i spend my time with doing my homeworks for tommorow, And after that i just spend the most of time with friends Tell us about your family and how you spend time together. I don't spend so much time with my parent's because they are busy with our Sushi resturant but sometimes when they get time we like to eat dinner together at a restaurant and do something social like go to the mall, Student Health Summary Are you currently or have you ever experienced any of the following? Health condition or injury other than routine illness (flu, etc.)? Allergy (pets, food, environmental substance) or allergic reaction? Physical disability? Learning disability or condition (ADD, ADHD, dyslexia, etc.)? Do you currently take any medications? Do you have, or have you ever had, any illness or disability that caused hospitalization? Have you ever experienced any of the following? Eating disorder? Significant weight loss or weight gain for any reason (including restricted eating, excessive exercise, vomiting, etc.)? Thoughts of suicide? Constant worry, anxiety, high stress, depression or sadness? Cutting or hurting yourself (or thoughts of doing this)? Emotional, physical or sexual abuse? Bullying or other social/family adjustment issues? Have you ever talked to a professional or another trusted adult (teacher, counselor, doctor, therapist, pastor, etc.) about any of the above issues? Submit

7 Electronic signature received from legal guardian

8 DKC HANS CHRISTIAN

9 DKC HANS CHRISTIAN

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