Local Rep Application

A Rewarding Opportunity

Few people have the opportunity to make as profound an impact on the world as PAX local coordinators (local representatives). These independent contractors help host families and high schools throughout the continental U.S. share their America with exchange students from more than 70 countries by:

  • Arranging semester and academic year homestays and high school enrollment for exchange students.
  • Generating interest in the local community.
  • Holding orientations for both families and students.
  • Guiding young, international visitors through personal and cultural adjustment.
  • Providing friends and neighbors in their community and the young people they host with positive, life-changing exposure to new cultures.

PAX is always improving local support around the country. Completing this application in lieu of your résumé is your first step in aligning yourself more closely with your passions for working with young people and exploring new cultures, pursuing your interest in meeting new people in your community, and putting to use your excellent communication skills and experience in education or sales.

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Basic Information

Prefix

Please select your appropriate prefix.
Name

Please enter your full name.
Address

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City

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State (*)

Please select your state from the list above
Zip

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Home Phone

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Work Phone

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Cell Phone

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Email (*)

Please enter a valid email address.
Date of Birth (*)
(ex. 04/02/1971)
Please use calendar to select your birthdate.
Where did you hear about PAX? (*)

Please specify how you heard about PAX
Please tell us where you heard about us.

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Education and Experience



Please list name of school(s) attended, years completed, year graduated and degree awarded.

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Employment: Please list employer, position, dates employed and reasons for leaving (list current or most recent job first).

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Volunteer or Related Experience: Please list organization, position and dates/length of service.

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Experience with Youth: Describe any experience you have had working with teens and families. Do you enjoy working with them?

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International Exchange Experience: Are you currently or have you ever worked or been affiliated with an international exchange student program? If yes, please indicate the name of the sponsoring organization that you were affiliated with and the dates of your affiliation. If not, what previous international or intercultural experience do you have, if any?

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Hosting Experience: Have you ever hosted a foreign student? If yes, when did you host, how many students did you host, from which countries did they come, and with which sponsor organization were they affiliated?

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What kind of issues have you experienced living or working with exchange students? Please describe.

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Background Information

Because PAX is responsible for the safety and well-being of foreign students who are minors, we ask that you answer the following questions openly and honestly.

Have you ever been charged with any crime? If yes, please explain.

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Have you ever had your drivers license suspended or revoked? If yes, please explain.

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Is there any history of child abuse, sexual abuse or emotional abuse in your family background? If yes, please explain.

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Is there anything in your background or current situation that would call into question your working with youth? If yes, please explain.

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Have you had any contact with any child protective services agency in the past? If yes, please indicate when and for what reason(s).

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Working as a PAX Coordinator



Area High Schools: List those high schools in which you would like to enroll PAX students.

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Recruiting Host Familes: Highlight any professional or volunteer experience that would be particularly useful in the coordinator position as you understand it, particularly as it relates to recruiting host families and supporting exchange students and host families. You might include sales experience, professional associations, or community or religious activities.

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Motivation: Please tell us why you would like to become a PAX community coordinator. What would you like to contribute to the program? What benefits and rewards would you like to receive from your participation?

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If employed outside the home, what are your hours of employment? Are we able to call you at work? If not, how would we reach you during working hours?

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What time of the day and week are you most readily available?

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What is your primary mode of transportation?

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References

Please provide two references who are not family members, one personal and one professional.



Prefix

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First Reference

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Relationship

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Years Known

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Home Phone

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Work Phone

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Email

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Prefix

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Second Reference

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Relationship

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Years Known

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Home Phone

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Work Phone

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Email

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