Paperwork / Forms
This Commitment form outlines some of the expectations and responsibilities associated with participation in the German Exchange Program.
Students who are offered to participate in the German Exchange Program will need to review these important expectations and responsibilities with their family in order to finalize their acceptance into the program.
The last page should be completed, signed, and returned to Mr. Goffinet.
Authorization for Admn of Medicine.pdfIn accordance with Connecticut and District requirements, this form must accompany any medication which a child brings with them on the Exchange. This includes all prescription medication (including epi-pens and inhalers) and any over-the-counter medication (including Tylenol and medication for motion sickness).
Note that the Prescriber (Physician, Physician Assistant, APRN, etc.) must complete the back (page 2) in order for a child to be authorized to self-administer medication. Program chaperones are unable to administer medication during such a trip.
This authorization should be completed, signed by a parent/guardian, and signed by a prescriber, before being returned to the school nurse. These must be submitted directly to the school nurse. Your prescriber's office is welcome to fax the signed form to us at 860-429-1020.
Forms must be received during the first 3 days of the school year to allow time for communication between the health office and program advisors.
This brief medical history form will help to share important health information with program chaperones. This is especially useful in the event of an emergency or sudden medical need.
Additionally, this form provides written consent for the German Exchange Program or its representative to obtain medical care for a student when necessary.
This does not need to be completed by a provider.