INTERACT by eKZRzAK

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									                         INTERACT




INTERACT
PROCEDURES




SHEBOYGAN DOWNTOWN ROTARY CLUB
1/26/2009




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                                                                            INTERACT




                                                                 TABLE OF CONTENT




INTRODUCTION ............................................................................................................................................................. 3
  WHAT IS INTERACT CLUB ....................................................................................................................................... 3
  PURPOSE AND OBJECTIVES OF THIS DOCUMENT ............................................................................................. 3
  INSTRUCTIONS FOR USING THE PLAN ................................................................................................................. 4
  COMMENTS ................................................................................................................................................................. 5
ACTION PLAN ................................................................................................................................................................. 6
  ASSUMPTIONS ............................................................................................................................................................ 6
  SUGGESTED FACILITY ADVISER RESPONSIBILITY .......................................................................................... 7
    Meetings ..................................................................................................................................................................... 7
    Projects....................................................................................................................................................................... 7
    Ongoing Support ........................................................................................................................................................ 8
    School Administration ............................................................................................................................................... 8
  TIPS FOR MAKING YOUR INTERACT CLUB A SUCCESS ................................................................................... 9
  ACTIVATION ............................................................................................................................................................. 10
    Activate Club Team. ................................................................................................................................................ 10
    Assign Tasks – Announce Event .............................................................................................................................. 10
    Con tact high school administrator .......................................................................................................................... 11
    Schedule operational startup at school site .............................................................................................................. 11
    Monitor progress. ..................................................................................................................................................... 12
    Establish ongoing communications with school officials ........................................................................................ 12
    Monitor ongoing activities at the school meeting. ................................................................................................... 12
    Post Event Review ................................................................................................................................................... 13
CLUB TEAM................................................................................................................................................................... 14
  TEAM ID           TEAM DESCRIPTION & OBJECTIVES .......................................................................................... 14
APPENDIX ...................................................................................................................................................................... 15
  PURPOSE AND OBJECTIVES .................................................................................................................................. 16
  CLUB PERSONNEL ADDRESS/TELEPHONE LIST .............................................................................................. 17
  ROPOSED INTERACT HIGH SCHOOL LIST.......................................................................................................... 18
  SCHOOL/STUDENTS ATTENDING INTERACT CLUB ........................................................................................ 19
  YOUTH VOLUNTEER AFFIDAVIT ......................................................................................................................... 20
  SPEAKER THANK YOU LETTER............................................................................................................................ 28
  COUNSELOR THANK YOU LETTER ..................................................................................................................... 29
  ACTIVITY LOG ......................................................................................................................................................... 30
  INTERACT PUBLICATIONS .................................................................................................................................... 31
    Service Projects ........................................................................................................................................................ 31
    Community Projects Database ................................................................................................................................. 31




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                                          INTERACT



                                      INTRODUCTION


WHAT IS INTERACT CLUB




 A Rotary service club for young people ages 14 to 18. Interact clubs complete at least two
community service projects, one of which furthers international understanding and goodwill. The
club draws from the student body of a single school or from two or more schools in the same
community.

Each year, Interact clubs complete at least two community service projects, one of which furthers
international understanding and goodwill. Through these efforts, Interactors develop a network of
friendships with local and overseas clubs and learn the importance of

       Developing leadership skills and personal integrity
       Demonstrating helpfulness and respect for others
       Understanding the value of individual responsibility and hard work
       Advancing international understanding and goodwill

As one of the most significant and fastest-growing programs of Rotary service, with more than
10,700 clubs in 109 countries and geographical areas, Interact has become a worldwide
phenomenon. Almost 200,000 young people are involved in Interact.


.

PURPOSE AND OBJECTIVES OF THIS DOCUMENT


This procedure provides a plan of action in developing and executing a successful Interact
experience for young high school students.

To ensure that the plan remains effective and current, it must be reviewed periodically, and
revised as appropriate. Changes in the configuration of the plan warrant immediate review of
the plan.

For this plan to be viable, all participants must be versed in all aspects of the plan. The best
training vehicle is for all club members and volunteers to actually participate at the Interact
Meetings.




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                                           INTERACT


The plan objective is to:

   Reduce confusion during the planning of Interact activities

   Minimize the number of decisions that must be made during the planning stage

   Provide information for high school administrators to identify and select qualified students for
    the Interact experience

   Provide any documents and registration steps for the schools and students

   Identify and select Speakers at Interact meetings

   Identify all physical and/or human resources that must be available in order to execute the
    actions defined in the plan

   Establish timetable

   Identify appropriate meeting sites

   Quantify the time and cost associated with Interact



INSTRUCTIONS FOR USING THE PLAN

This plan becomes effective each year when planning and executing the Interact activities at area
high schools. Normal problem management procedures will initiate use of this plan and allow for
all Rotary participants to understand and execute their part in providing a successful and
meaningful experience for the students.

The plan is activated as soon as the Interact Committee is selected; chairperson nominated, and the
dates for the Interact meetings are scheduled with school principals. The plan should be activated
by contacting the members of the Interact Team and following the appropriate ACTION PLAN
activities.

Notify the club members as to plan meetings by those listed on the Club Personnel
Address/Telephone List as quickly as possible. This list can be found in the Appendix.

All activities during the planning period will be under the control of the club chairperson as
described in this plan. Use the Activity Log to keep track of activities as they are assigned and
completed.

The Public Relations Club Chairperson is responsible to communicate with the press as to which
schools and when meetings will take place.


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                                          INTERACT




COMMENTS

Initial review of the plan should be scheduled in advance by chairperson and members to update all
relevant information which can and will change year-to-year. These changes to the plan should first
be applied before executing the ACTION PLAN. See “Purpose and Objectives” in the Appendix
section to identify those forms requiring updates each year. Other forms may also need updates
depending on circumstance. As familiarity with basic procedures increases, new members will find
it much easier to play their part in executing a successful experience for students.

Every plan should have clearly defined objectives. A detailed plan, with data and expected results
should be prepared before meetings. All problems encountered during meetings should be
documented, and the plan should be modified to address any problem areas or inaccuracies.


As new steps are added, the plan process should be modified to include these new steps. The
modification of the plan procedures for these new steps will insure the continued success of the
Interact experience.




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                                           INTERACT




                                         ACTION PLAN




This section identifies the activities associated with each phase of the plan. It contains information
necessary to determine club team personnel, and establish work preparation for Interact activities.




ASSUMPTIONS


Although the steps defined in the action plan provide a basic flow that should be followed during
the planning of Interact they cannot be considered all-inclusive. In addition to the steps outlined,
the execution of the plan is based on the following assumptions:


      Club members are prepared to deal with procedures without the need to reference detailed
       written steps.

      Club members are versed in the day-to-day scheduling procedures.

      Club members and volunteers have signed off on all forms and Youth Volunteer affidavit
       documents as required for student/member/volunteer interface. It is the duty of all
       Rotarians, Rotarians’ spouses, partners, and any other volunteers to safeguard to the best of
       their ability the welfare of and to prevent the physical, sexual, or emotional abuse of
       children and young people with whom they come into contact.

      Club leader and/or assigned personnel will be available to make decisions regarding plan
       activities and to address unanticipated events.

      Personnel required to perform special functions (speakers, support staff, volunteers, etc.) are
       trained for those roles and are readily available.

      Faculty advisers for each school have been identified. (See advisers responsibility below)




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                                            INTERACT



SUGGESTED FACILITY ADVISER RESPONSIBILITY
Faculty advisers at school-based Interact clubs are essential to the club’s success. They must attend
all meetings, assist with service projects, and provide guidance to the club’s board of
Directors, and liaise between the school administration and sponsoring Rotary club.

Meetings

• Help with arranging meeting dates and times, but allow Interactions to carry out meetings.

• Attend all club meetings and ensure they run smoothly.

• Assist with campaigns and elections of Interact officers.

• Help with guest speaker arrangements.


Projects

• Advise on service project implementation, especially for in-school activities.

• Maintain a calendar of Interact events to avoid conflicting with other school activities.

• Attend all Interact activities outside of school hours, or help arrange transportation and
chaperones.

• Arrange logistics of project sites and any equipment needs.

• Determine if projects require special school approval or additional insurance.

• Coordinate joint fundraising and service activities with the sponsoring Rotary club.
Interact Club Board of Directors

• Coordinate a leadership training workshop for new officers.

• Assist the board members in understanding their duties and reporting their activities to other
members of the club.

• Verify that Interact committees meet their requirements and deadlines.

• Recommend that Interactors participate in leadership seminars and any other Rotary-sponsored
youth opportunities.

• Keep the board members organized, realistic in their expectations and limitations, and focused on
the goals of the club.



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                                           INTERACT



Ongoing Support

• Help maintain accurate club records and documentation, and monitor the flow of club funds.

• Oversee editing, publication, distribution, and announcement of Interact newsletters.

• Guide efforts to recruit members.

• Work on Interact promotion with the school newspaper staff and local media.


School Administration

• Verify that members meet school academic requirements.

• Approve all Interact-related announcements and communications.

• Act as a liaison between the sponsoring Rotary club and the school principal, faculty, and staff.

• Gain support from colleagues and parents.

• Keep apprised of changing school policies that can affect the administration of the Interact club.




Review “Interact Facility Adviser Guide” for additional information




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                                            INTERACT




TIPS FOR MAKING YOUR INTERACT CLUB A SUCCESS


The success of an Interact club depends greatly on the strength and participation of its advisers.
Experienced advisers have shared the following tips:

• Dedicate yourself to your role. Interact advising requires a substantial time commitment.
A consistent faculty adviser is important to a club’s success.

• Maintain a positive and enthusiastic attitude.

• Work closely with the Rotarian adviser.

• Realize that new clubs need more guidance. Be willing to ask questions and seek assistance from
the Rotary club, your school, and community.

• Invite Rotarians to attend and speak at Interact club meetings regularly.

• Know the community and its resources.

• Be aware of other service clubs in the school and community, and maintain positive, cooperative
relationships with them.
.
• Allow Interactors to fail since it can be a good learning experience. But step in if risk
management issues are compromised.

• Encourage Interactors to resolve disagreements on their own, but arbitrate when necessary
.
• Motivate by praising successes, and encourage optimism when activities fail.

• Realize that youth activities change throughout the year, and emphasize the importance of
consistent attendance.

• Work with other Interact clubs and advisers in the district.

• Communicate regularly with the district Interact chair and suggest that an annual district adviser
training seminar be organized.

• Encourage Interactors to participate in district training events offered in the area.




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                                         INTERACT




ACTIVATION



Activate Club Team.

         Chairperson contacts all club members of the team, establish meeting time, place, and
          date with which to discuss the coming year event of establishing Interact activities at
          participating high schools.

         If the team chairperson is not available, the co-chairperson should assume his
          responsibility and complete this activity.

         Chairperson has reviewed and updated this document as to schools, school contacts, and
          any documents related to the establishment and the execution of an Interact Club.




Assign Tasks – Announce Event


         Distribute copy of Interact Procedures to each member.

         Determine schools to be contacted in preparation to school visits (see school list in
          Appendix).

         Discuss “Suggested Facility Adviser Responsibility” and “Tips for making your Interact
          Club a success” as described above.

         Chairperson assigns team members to duties and responsibilities.

         Select form(s) from Appendix which apply to team member assignments. Forms
          directed to schools should be sent out as soon as possible. This action should be initiated
          early in the school fall semester.

         Update form information as required.

         Chairperson announces Interact meeting schedules and informs Public Relations
          Chairperson of event for public announcement.




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                                         INTERACT

         Assuming the Interact Club is “A GO” at the school the Rotary should register the club
          with district 6270 using the forms in the Appendix and the Interact Handbook for
          complete information. Not all schools will, can, or want to participate in Club Interact.




Con tact high school administrator

         A member of the Interact subcommittee should meet with school officials to explain the
          program and its advantages. Rotarians and school officials should work together to
          determine membership requirements, club policies, the time and location of Interact
          club meets. A facility adviser should also be chosen from the school staff to conduct
          meeting and be the interface between Rotary member and school officers and students.
          In some instances the Interact Club may already be established since initialized in the
          prior year(s).

         Provide schools with forms and documents required for students wishing to participate
          in the Interact Program. This may include “Interact Membership Application Form” and
          “Interact Club Organization List” for a first-time school club establishment. “Standard
          Interact Club Bylaws” and “Standard Interact Club Constitution” should be provided to
          the new club. (See appendix for the above forms). A copy of the “Interact Handbook”
          should also be provided to the club facility adviser.

         The school facility adviser which will attend all meetings and be the liaison between the
          school administration and sponsoring Rotary Club.



Schedule operational startup at school site


         Produce time table and ensure all team members are provided with schedule (see
          Appendix). Try for a club enrollment of at least 15 students.

         Have club students elect club officers.

         Assist club students in selecting the two club objectives of: 1), local community project
          and 2), International project. Verify the availability of documentation, and supplies to
          help students in project selection.

         Speak with club president and students to select and schedule monthly speakers and
          subject matter. This should be planned well ahead and with the help of the facility
          adviser to help schedule speakers.

         Schedule and attend local Rotary meeting


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                                         INTERACT




Monitor progress.

         Continue to monitor the clubs activities and students participation. Are students excited
          and show interest? What can be done to improve club agenda?

         Provide Rotary Board members with club activity updates.




Establish ongoing communications with school officials


         Is the club meeting the objectives of the students and the school?

         Review number of students scheduled and number of students actually in attendance.

         Review scheduled speakers and times



Monitor ongoing activities at the school meeting.

         Communicate with school site personnel on any additional needs or issues arising
          during the meetings.

         Communicate with schools as to any unforeseen problems arising with students.

         Monitor relationships between students and students; students and club team members;
          and students and volunteers other than club members.

         Monitor speakers and students relationship during scheduled presentations.

         Monitor conditions which could call for meeting cancellations.

         Monitor students attending meeting, and how often.




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                                       INTERACT




Post Event Review


         Provide a student evaluation forms, for both Interact Club and Speaker. Summarize the
          findings and retain for further review by club committee. Use these reviews to better
          prepare, and modify future Interact Club Events.

         Committee should meet and discuss Interact Club Event using evaluation forms. What
          needs changing; What if any problems identified, what we can do better next year.

         Apply any changes to the Interact Club Event Procedures and apply updates to web-site
          document.




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                                                  INTERACT




                                                 CLUB TEAM



This section addresses team structure, general team activities, and team assignments.




TEAM ID                    TEAM DESCRIPTION & OBJECTIVES


                           .


CHAIR                      Interact Chairperson

                           The Club Chairperson performs all administrative functions pertaining to the
                           club event, provides overall direction for the event, and is responsible for
                           communications with Rotary Club Services for any public announcements.
                           He like other club members will be involved in the daily activities of the
                           Interact Event and may also be a designed speaker during the ongoing
                           monthly meetings.


TEAM                       Personnel/Volunteers

                           This team is comprised of Interact Club members attending Interact meetings
                           and responsible for on-going assigned duties and may also be designed
                           speaker(s) during the monthly meetings.




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INTERACT




APPENDIX




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                                                  INTERACT




PURPOSE AND OBJECTIVES


The Appendix contains documents related to the Interact meets but that would not be appropriate in any of the previous
sections. indicate forms requiring change each year.


Items that are included in the preparation, execution and follow up to the event are:

            Club Personnel Address/Telephone List

            Proposed Interact High School List

            List of Sheboygan County High Schools and school contacts

            Students Attending Interact Meetings

            Youth Volunteer Affidavit

            Interact Membership Application Form

            Interact Club Organization List

            Standard Interact By-Laws

            Speaker Thank you Letter

            Counselor Thank You Letter

            Activity Log

            Interact Publications




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                                 INTERACT




                          SHEBOYGAN ROTARY CLUB
                              INTERACT CLUB



CLUB PERSONNEL ADDRESS/TELEPHONE LIST


Name               Position                  Address   Phone Numbers

                   Chairperson                         Home (920)
                                                       Work (920)
                                                       Pager (

                   Club Member                         Home (920)
                                                       Work (
                                                       Pager (

                   Club Member                         Home (920)
                                                       Work (920)
                                                       Pager (

                   Club Member                         Home (
                                                       Work (920)
                                                       Pager (

                   Club Member                         Home (920)
                                                       Work (920)
                                                       Pager (

                   Club Member                         Home (920)
                                                       Work (920)
                                                       Pager (

                   Club Member                         Home (920)
                                                       Work (920)
                                                       Pager (

                   Club Member                         Home (920)
                                                       Work (
                                                       Pager (




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                                      INTERACT




ROPOSED INTERACT HIGH SCHOOL LIST


2008
   School    Principal    Last      Counselor       Last      School         City      Zip
   Name        First      Name      First Name      Name      Address
              Name

Cedar        John        Hocking    Sue            King     321 N. 2nd Cedar          53013
Grove-                                                      St.        Grove
Belgium
Elkhart      John        Quella     Melanie        Bunyea   201      N. Elkhart       53020
Lake-                                                       Lincoln St Lake
Glenbeulah
Howard       Mark        Holzman    Dale           Nennig   401           Howards     53083
Grove                                                       Audubon       Grove
                                                            Rd.
Kohler       Lance       Northey    Laura          Multer   333 Upper     Kohler      53044
                                                            Rd.
Oostburg     Scott       Gruepnik   Andy           Bonestro 410 New       Oostburg    53070
                                                            York Ave
Plymouth     Dan         Mella      Charles        Hansen   125           Plymouth    53073
                                                            Highland
                                                            Ave.
Sheboygan    Rick        Schultz    Jenny          Marks    1042          Sheboygan   53083
North                                                       School
                                                            Ave.
Sheboygan    Lee         Benish     Kevin          Heling   3128     S.   Sheboygan   53081
                                                              th
South                                                       12 St.
Sheboygan    Jim         Pingel     Myma           Lastusky 3323          Sheboygan   53081
Lutheran                                                    University
                                                            Dr.
Sheboygan    Wayne       Dyksta     Wayne          Dyksta   929           Sheboygan   53081
County                                                      Greenfield
Christian                                                   Ave
Sheboygan    Scott       Sabol      Bill           Van Dyk 220            Sheboygan   53085
Falls                                                       Amherst       Fall
                                                            Dr.




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                                         INTERACT




SCHOOL/STUDENTS ATTENDING INTERACT CLUB




November 6-7, 2008

     SCHOOL                  NAME              SCHOOL                          NAME

Home school          Harris Weils        Sheboygan Co. Christian   Joanna Anderson
                     Naomi Wells                                   Michelle Dulmes
                                                                   Zachary Flipse
Cedar Grove -        Mary Asma                                     Brandon Wisse
Belgium
                     Nicole Gottsacker
                     Alex Isken          Sheboygan Falls           Daniel Duda
                     Alex Rogers                                   Margo Clark

Elkhart Lake -       Emily Van Oss       Sheboygan Lutheran        Jessica Christian
Glenbeulah
                     Cody Liebe                                    Erika Herrmann
                     Brianna Diestler                              Dan Salzbrenner
                     Devon Platfoot                                Kimberly Buck
                     Crystal Zabel
                                         Sheboygan North           Kaitlyn Laning
                                                                   Jeffrey Boldt
Howards Grove        Stephanie Bergman
                     Chelsea Krenn       Sheboygan South           Jeanie Reinthaler
                     Jennifer Moehring                             Sara Becker
                     Zach Steven                                   Michelle Beinemann
                                                                   Alyssa Davis
Kohler               Elizabeth Diehl                               Aaron Brown

Oostburg             Brent Loose
                     Phillip Harder
                     Daniel Leitzke

Plymouth             Skylar Kraemer
                     Rachel Sommer
                     Lindsay Mauk
                     Nina Rortvedt




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                                                         INTERACT



                                                    Sheboygan Rotary Club
                                                      INTERACT CLUB

YOUTH VOLUNTEER AFFIDAVIT




ROTARY INTERNATIONAL
District 6270
Volunteer Affidavit

District 6270 is committed to creating and maintaining the safest possible environment for all participants in
Rotary Youth activities. It is the duty of all Rotarians, Rotarians’ spouses, partners, and any other volunteers
to safeguard to the best of their ability the welfare of and to prevent the physical, sexual, or emotional abuse
of children and young people with whom they come into contact. When completed see page 4. FOR ALL
VOLUNTEERS OR ADULT RESIDENTS IN A HOST FAMILY, DO NOT USE AS A HOST FAMILY
APPLICATION.
PERSONAL INFORMATION
Name: _______________ Date of birth ____/_____/_______
Please use your full legal name—first-middle-last
Address: ______________________________________
City: State/Province: Zip/Postal Code:
Home Phone: ___________________________ Email: ___________________________
Business Phone: ___________________________ Fax: ___________________________
How long at this address? (If less than five years, please attach additional sheets, if necessary)
Government identification (e.g. Social Security Number): ______ _____ _____________ Gender M F
Are you a member of a Rotary club? Yes No
If yes, please give club name and year joined:
Position Applied for:
Have you held a Youth Exchange position in the past? Yes __________ No___________
If yes, what position and when?
_______________________________________________________________________
EMPLOYMENT HISTORY (5 years – please attach additional sheets, if necessary)
Current Employer:
Address/City/State/Zip:
Telephone: Position:
How long with this company? Supervisor’s Name:
Previous Employer:
Address/City/State/Zip:
Telephone: Position:
How long with this company? Supervisor’s Name:
                                                  Page 1 of 4



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                                              INTERACT

     VOLUNTEER HISTORY WITH YOUTH (5 years – please attach additional sheets, if necessary)
Organization Name:
Address/City/State/Zip:
Telephone: Position:
Dates Held: Director’s Name:
Previous Organization:
Address/City/State/Zip:
Telephone: Position:
Dates Held: Director’s Name:
PERSONAL REFERENCES (not relatives and not more than one former or current Rotarian)
1. Name:
         Address/City/State/Zip:
         Telephone:
         Relationship: ________________________________________
2. Name:
         Address/City/State/Zip:
         Telephone:
         Relationship: ________________________________________
3. Name:
         Address/City/State/Zip:
         Telephone:
         Relationship: ________________________________________
QUALIFICATIONS AND TRAINING
What qualifications and/or training do you have relevant to Youth Exchange or this position? Please
describe in full.
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_________________________________
CRIMINAL HISTORY
1. Have you ever been convicted of or plead guilty to any crime(s)?     yes  no
2. Have you ever been subject to any court order involving any sexual, physical or verbal abuse including
         but not limited to any domestic violence or civil harassment injunction or protective order?   yes
         no
If yes, describe in full. Also indicate dates(s) of crime(s) and in which country and state each took place.
(Attach a separate sheet if needed)
_______________________________________________________________________________________
_______________________________________________________________________________________
______________________
                                                     Page 2 of 4




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                                                INTERACT

Any driving violations or accidents? □ Yes □ No
_________________________________________________________
If yes please explain
_______________________________________________________________________________________
___________
Drivers License Number ______________________________ Issued by _____
State
WAIVER/CONSENT/RELEASE
I certify that all of the statements in this affidavit, and in any attachments hereto, are true and correct to the
best of my knowledge. I also certify that I have not withheld any information that would affect this affidavit
unfavorably, if disclosed. I understand that any omission of facts or misrepresentation will result in my
elimination from consideration for any volunteer position with the District 6270 Youth Activities program or
its affiliates. I further certify that I understand that District 6270 Youth Activities program’s intent is to deny
a position to anyone convicted of a crime of violence or a crime against another person.
I hereby give my permission for District 6270 to investigate, verify and obtain information given in this
affidavit, including searches of law enforcement and published records (including driving records and
criminal background checks), contact with former employers and reference interviews. I understand that this
information will be used, in part, to determine my eligibility for a volunteer position with the District 6270
Youth Activities programs. I also understand that as long as I remain a volunteer here, the criminal history
records check may be repeated at any time. I understand that I will have an opportunity to review the
criminal history and that there is a procedure available for clarification, if I dispute the record as received.
I specifically acknowledge that the District 6270 or its affiliates will inquire about, and I authorize them to
verify, my prior employment, experience, personal references, background, including criminal background
checks which may contain arrest and conviction data. I waive any right to assert that such an investigation or
request constitutes an invasion of my privacy. I recognize that such inquiries are in the interest of all persons
involved the District 6270 Youth Activities and I fully consent to such investigations.
IN CONSIDERATION of my acceptance and participation in the Youth Activities programs, I, to the full
extent permitted by law, hereby release and agree to save, hold harmless and indemnify, all members,
officers, directors, committee members and employees of the participating Rotary Clubs and Districts, and
of Rotary International (“Indemnities”), from any or all liability for any loss, property damage, personal
injury or death, including any such liability which may arise out of the negligence of any of the Indemnities,
which may be suffered or claimed by me as a result of an investigation of my background in connection with
this affidavit.
I further agree to conform to the rules, regulations, and policies of Rotary International, the District 6270
Youth programs, and understand that my service can be modified or terminated, with or without notice or
cause, at any time, at the option of either the District 6270 or its affiliates, or at my option. I understand and
agree that the District 6270 program or its affiliates may, in their sole discretion, decline to accept my
application for volunteer services with or without cause.
I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THE ABOVE AFFIDAVIT,
WAIVER, CONSENT AND RELEASE, AND THAT I SIGN THIS FORM VOLUNTARILY.
Signature of Applicant (In Blue Ink) Please Print Name Date
                                                      Page 3 of 4




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                                                  INTERACT

                                  ROTARY INTERNATIONAL
                                              District 6270
                                             Privacy Notice
Your Privacy is Important to Us
We want you to know that protecting the privacy of your personal information is one of our top priorities. We value our
relationship with you. The very nature of our relationship with you requires us to collect or share certain types of
information about you. We want you to know what information we collect, how we protect it and how we may use it.
This privacy notice explains how we use and protect potential, current and former volunteer and host family
information. Please read it carefully.
What Personal Information Do We Have?
We collect information, such as name, address, social security number, and employment status, as outlined on the
application you completed for us. The type of information we collect depends on your request and may include:
     • Information we receive from you when you complete the application as a volunteer or host family;
     • Information we receive from your references in connection with your application.
     • Information we receive from third parties (such as motor vehicle reports and criminal background information).
How Do We Use Your Personal Information?
We may use your personal information and may provide it to authorized personnel from the U S Department of State
and firms that conduct audits of our records.
      • To approve your request;
      • To fulfill legal and regulatory requirements;
We do not disclose any personal information about our potential, current and former volunteers and host families unless
required by law.
We will not disclose any information we collect about you unless authorized by you to do so or as permitted by law.
We may share such information without authorization, to the extent permitted by law, with third parties or affiliates
assisting us, such as those who assist us investigating your application.
Protecting the Confidentiality of Your Personal Information
We only allow access to your personal information to those individuals who need it in order carry out the purposes of
our program. Individuals who have access to your personal information are required to keep it strictly confidential. We
provide training to our volunteers about the importance of protecting the privacy of your information. We maintain
safeguards to protect your personal information.
                                                Page 4 of 4
When this form is completed send it along with a check payable to District 6270 for $3.95 to:
                                              District Office
                                        10405 W Manor Park Drive
West Allis, WI 53227




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INTERACT




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INTERACT




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INTERACT




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INTERACT




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                                                    INTERACT




SPEAKER THANK YOU LETTER




                              Rotary Internet Club


Dear xxx,,




First of all, on behalf of Sheboygan Downtown Rotary Club and students of xxxx High school, THANK YOU for
volunteering your time and your ability to provide a unique learning experience to a group of Sheboygan County high
school students at our school.

It is through the Interact program that students are involved with both local and international project helping to build
better understanding among all citizens of the world.

Again, thank you for your participation.



Signed;

XXXXX




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                                           INTERACT




COUNSELOR THANK YOU LETTER




                         Rotary Interact Club
____________________________________________________________________________________



November 4, 2007

Dear Counselor,

Thank you for your school’s continued participation in the Sheboygan Rotary’s Internet program.
Attached you will find the list of participants with those who actually attended. All of the students
were active participants in the program and got along well with each other. They were not only
attentive, but also extremely helpful when discussing topics and bring their thoughts into the
meetings.

It was again a great experience for our club to work with your students. We look forward to
working with students from your schools again next year.

Thank you for your great students and continued support of the Interact program.

Sincerely,

Jake Kraus
2007 Interact Chairperson




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                         INTERACT


                    SHEBOYGAN ROTARY CLUB
                        INTERACT CLUB
                           2008 - 2009



ACTIVITY LOG


         ACTIVITY         Who is responsible   Location   Date/Time




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                                           INTERACT


                                 SHEBOYGAN ROTARY CLUB
                                    HIGH SCHOOL NAME
                                         2008 - 2009




INTERACT PUBLICATIONS

Several RI publications can help you organize and administer an Interact program. The following
items are available from RI Publications Order Services or the international office serving your
area; you can also order or download materials on the RI Web site:

Interact Handbook — A comprehensive program resource that includes information on
organizing and maintaining an Interact club. It includes project examples and forms and
constitutional documents. A must for all Interact advisers. (654-EN)

Interact Brochure — A promotional piece to inform potential members about club activities and
purpose. (600-EN)

Serious Fun — A nine-minute video for promoting Interact among prospective members. Features
Interact projects in Canada, Cyprus, Ireland, Japan, and the United States. (650-EN)


Service Projects

Rotary club community service information and activities can easily be adapted to fit Interact clubs.
The following publications provide valuable details on how to select, plan, implement, and evaluate
service projects and highlight many successful ones:

Communities in Action: A Guide to Effective Projects (605A-EN)

A Menu of Service Opportunities (605B-EN)


Community Projects Database

This searchable, online database (at www.rotary.org/programs/projectsdb) of service projects
implemented by Rotary clubs and districts, Interact clubs, and other Rotary-sponsored programs
provides ideas for a wide variety of projects and the opportunity to benefit from the experience of
others. Each entry includes a short description of the project and contact information for the project
sponsors. Others seeking to start a similar project can contact the sponsors for more-detailed
information and to exchange ideas.




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