Section 1 of 1 in this document

Gastonia Sister Cities Exchange Trip 2026

Student Application

This information in this application will be used for all documentation should you be selected.

Please take your time to make sure all emails, phone numbers and information is correct. Legal names should be written as they appear on your documentation (birth certificate, license, passport, etc).

Write your essay on a separate document and be prepared to upload (copy and paste) when you submit.

First Choice Travel Location:

Germany

Peru

Either one

I. Student Information:

Nick name or preferred name:

Full Address:

Address or Location

Student Cell Number:

Birth date:

Email:

Citizenship Status:

U.S. Citizen

Permanent Resident

Resident Alien

I have or can obtain a passport to travel to/from the United States:

I hold a valid US Passport

US Citizen able to obtain US Passport

I hold a valid passport from another country

Hold or able to obtain a passport from my home country

My passport number is:

Unisex Adult T-Shirt Size

My Parents/Guardians know that I am applying to this program:

Yes

How did you hear about this program?

Friend who has been (word of mouth)

Flyer

Social Media

School teacher or counselor

Other

If "friend" or "other" please include name or explain:

Please upload a recent headshot or school photo that could be used for media purposes., as well as sharing a profile with exchange host families.

II. Academics and Extracurriculars

Name of Gaston County School attending:

If Other, please name:

2026-2027 Grade:

Freshman (9th)

Sophomore (10th)

Junior (11th)

Senior (12th)- only for 5 year programs (GEC)

Current Cumulative GPA:

In a few sentences, describe yourself.

Additional scholastic programs (Advanced Placement, International Baccalaureate):

Language Courses or abilities (school or on own, how long did you study, level of proficiency)

School clubs (Interact, Robotics, National Honor Society):

Athletics or Arts Participation (in school or outside of school):

Community Involvement (ex: Mayor's Youth Council, Religious Involvement, Scouts):

Please list any special programs through School or Community, Honors or Awards you have achieved (Scouts, National Honor Society, Governor's School, Commissioner's School):

Employment: List any past or present work, and length of time employed.

III. Family Information:

Mother's/Guardian's Name:

Mother/Guardian Occupation:

Best Phone Number:

Best Email:

Father's/Guardian's Name:

Father/Guardian Occupation:

Best Phone Number:

Best Email:

Emergency Contact Name:

Emergency Contact Phone Number

Emergency Contact Relationship

Sibling (over age 18)

Grandparent

Aunt

Friend of Family

Uncle

Step-parent

IV. Student Travel Experience

What is the longest time you have been away from your family?

One night

One weekend or long weekend

A week or more

I haven't been away from my family overnight

Describe any trips you have experienced without your family, Stateside or otherwise. Please include location, purpose, who did you travel with, length of time etc. If none, write none.

Have you traveled by plane before?

Have you ever hosted an exchange student or business person before?

Please describe trips you have experienced outside of the United States (if any). Include the location, year, and purpose (vacation, family visit, study abroad, etc.) If none, write none.

5. Do you have any dietary restrictions? (Listing details helps us place students with the best host families and does not preclude selection to the program).

YES

If YES, please explain:

6. Do you have any physical restrictions, impairments, or allergies that will limit placement options or participation in everyday family and/or school activities? (Listing details helps us place students with the best host families and does not preclude selection to the program).

YES

V. Essay

The essay needs to address:

What personal goals do you have for this experience?
What do you hope to experience about the host country’s culture, people, and way of life?
In what ways do you think this experience will impact your future — in school, your community, or your career?

Please put your full name at the top of the Essay.

400-500 words.

It should be in your own words, do not use AI.

Please upload your essay here.

VI. Letters of Recommendations: Use PDF form or link on website

You will need two letters of recommendation from adults that know you well and can speak to your abilities and character.

1 Teacher Recommendation is required.

You may choose to submit a 2nd teacher recommendation, or another community member such as a youth leader, coach or mentor.

If you have hard copies copies, you should scan and upload them to submit with this application.

You can also have your references use the online form and submit directly to the selection committee.

Your application is not complete until both letters of reference are recieved online. All parts of the application are due by Friday October 16 2026.

Upload any letters of recommendation you have here:

VII. Please answer these questions in reference to housing. Participation in the Sister Cities Program involves hosting an exchange student in the Fall of 2027. Details on exact dates will come later in the program year.

1. How many people live in your household?

2. Will your family be willing to host an exchange student for approximately two (2) weeks?

YES

3. What kind of accommodations will you provide for your host student? (share a room/have their own room, etc.)

4. Pets you have in the home:

Dog

Cat or Rabbit

Bird

Reptile

Fish

Small Mammal (hamster, rat, gerbil, guinea pig etc)

None

Other

If YES, please explain:

How do you get to/ from school?

Untitled

When the exchange student comes, the host family will need to provide transportation for the student every day to downtown Gastonia for the program. Are you able to provide transportation for the student for the 2 week exchange?

VIII. Student Signature

We have limited scholarships each year. If you would like to apply for a scholarship, please check the box below and an additional form will be sent to the emails listed for the parents.

Are you declining to apply for a scholarship?

Yes, I am declining.

No, I want to apply for a scholarship.

By signing below I attest that I have completed the application for the Sister Cities Program and understand the requirements and guidelines. I also acknowldege that the answers in this application are my own work, and I am truthfully replying to all questions.

I understand that my photo and likeness may be used and that there may be videos for purposes of documenting or advertising for the trip by Gastonia Sister Cities, the Shelby Star (Gaston Gazette), Gaston County School publications or other vetted entities. I acknowledge that there will be a media project that I will participate in and my work may be used to support the program in visual, audio, or other media methods and that I will be credited for such work but not compensated through the program.

I, the undersigned student, affirm that as a participant:

I will represent my home community with respect and responsibility.
I will follow the rules and expectations outlined by the program organizers and chaperones.
I will maintain regular communication with my group leaders.
I will conduct myself in a manner that reflects positively on myself, my family, and my school.
If selected from the applicant pool I will be available for the group interview on Saturday November 8, 12 pm in downtown Gastonia.

Student Signature:

First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

Today's Date:

Receipt

You will be provided with a Receipt upon submission.