South Africa Exchange Program
Please complete the application below to be considered as a participant in the South Africa Exchange Program at the Herschel School for Girls in Cape Town, SA. You must be a 10th grade student in 2023-24 to participate. You will travel to South Africa in the summer of 2024 and your counterpart will come to Baltimore in the fall of 2024 (your junior year).  Application is due November 1st, 2023
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Email *
Applicant's Full Name *
Captionless Image
 Student's Date of Birth
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Family's Home Address
 Home Phone Number
Parent/Guardian's Name
Parent/Guardian's Address
Parent/Guardian's Cell Phone Number
Parent/Guardian's E-mail
Parent 2/Guardian 2 's Name
Parent 2/Guardian's 2 Address if different from main parent/guardian
Parent 2/Guardian 2's Cell Number
Parent 2/Guardian 2's E-mail
If not chosen for this particular exchange would you like to be considered for other exchange opportunities? *
Do you have any allergies your host family should be aware of?
Do you have any limitations (physical or emotional) your host family should be aware of, and if so, do you need any accommodations?
Do you require any meal accommodations (nutritional: vegan, vegetarian, etc; religious; kosher, etc..)
What extra-curricular activities, community service, sports, religious activities, etc... are you involved in?
What do you hope to learn from participating in this exchange?
What do you hope your host community learns from you?
What do you think will be your greatest asset as a host to a foreign exchange student?
What do you think will be your greatest challenge as a foreign exchange student?
What do you think will be your greatest challenge as a host to a foreign exchange student?
Who lives in your home with you? Please give names, relationship and ages.
Do you have any pets in the house? If yes, please give kind (cat, dog, etc) and name.
Will the host student have her own room or share with you or other family member?
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If the host student will share room and/or bathroom, please explain arrangement.
What other information about yourself or your family would you like to share with the selecting committee?
A copy of your responses will be emailed to the address you provided.
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