Student Exchange Survey & Consent Form | 5-Day Student Exchange Program

SECTION A: STUDENT INFORMATION

Full Name *

Age *

Class *

School Name / Institution *

Location *

SECTION B: MOTIVATION & EXPECTATIONS

Why do you want to join this exchange?

Academic exposure Cultural immersion Networking opportunities Personal growth

Any concerns (travel, food, language, finances)?

SECTION C: ESTIMATED COST (SUITABLE BUDGET)

Select Suitable Budget Range *

₹18,000 – ₹25,000 Per Student

₹30,000 – ₹40,000 Per Student

₹40,000 – ₹50,000 Per Student

This cost includes:

Travel (Train/Air)

Accommodation

Meals

Local Transport

Academic & Cultural Activities

SECTION D: CONSENT AGREEMENT

I, [Student Name], hereby consent to participate in the 5-day student exchange program organized by [Institution Name].

I understand the costs involved and agree to bear them. * I consent to participate in all academic and cultural activities. * I agree to follow institutional rules, safety guidelines, and code of conduct. * I allow my feedback to be used for program evaluation and improvement. *

Signature (Type Full Legal Name) *

Date *

Cultural Immersion & Exchange

SECTION A: STUDENT INFORMATION

SECTION B: MOTIVATION & EXPECTATIONS

SECTION C: ESTIMATED COST (SUITABLE BUDGET)

This cost includes:

SECTION D: CONSENT AGREEMENT

Your safety, learning, and growth are our priority.