Parent Questionnaire

Questionnaire for Parents
Applicant Name*
First Last
Parent / Guardian Email Address*
Why do you want your son/ daughter to go to Costa Rica?*
What do you hope that your student will get out of or bring home from his/ her 2 month stay?*
Has your student ever been diagnosed or treated for any disease or disorder such as, but not limited to, cancer, anxiety, depression, or eating disorder? If yes, please explain.*
Is your student currently taking any prescription medications? Please list. Your student will need to carry a copy to Costa Rica as well as give a copy to the chaperones.*
What is your son/ daughter excited most about going to Costa Rica?*
What fears does he/ she have about going?*
What fears do YOU have about him/ her going?*
What could arise as a problem in Costa Rica? And how would you handle it?*
Why should we choose your student?*
I acknowledge that my family is obligated and required to host a Costa Rican student prior to my child’s travel or the following winter. We are also required to submit the contact information for another family who will apply to host the winter following my child’s travel. If my child is a senior or we are unable to personally host, we commit to submitting contact information for two other families who are available and willing to host the following winter. This information will be submitted at the May overnight orientation, or my child may lose his/her traveler status.
Parent E-Signature*
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Questionnaire for Parents