Form SV-2010-0024 Future Leaders Exchange Program (FLEX) Post-Program Surv

Future Leaders Exchange Program

[Insert Academic Year] Post-Program Survey

There are only a few weeks left until you finish the FLEX program. We hope that you have had a very enjoyable year. Before you return home, we would like to ask you some questions about your experiences and thoughts. These questions will be used to evaluate the FLEX Program and to make it better for future FLEX participants. Your answers will be strictly confidential, and the data collected will only be used for analytical and evaluative purposes. Please answer all of the questions as best you can. This is not a test—there are no right or wrong answers. Your thoughts and opinions are important to us. Thank you for your help. We hope you have fun during the rest of your program. Have a safe journey home!

Privacy Act and Paperwork Reduction Act Statements:

The information solicited on this survey is requested pursuant to the Government Performance and Results Act of 1993 (P.L. 103-62) and the Mutual Educational and Cultural Exchange Act of 1961, as amended, also known as the Fulbright-Hays Act (22 U.S.C. 2451, et seq.). In order to ensure that the U.S. Department of State’s international exchange programs meet statutory program requirements (22 U.S.C. 2460(c)), the Department’s Bureau of Educational and Cultural Affairs (ECA) regularly monitors the programs, gathers data about program accomplishments, and evaluates selected ones. ECA uses the information collected to inform program design, management, and funding. All personal information that is collected through surveys is considered confidential. All responses are coded to ensure the confidentiality of individual responses. Data collected under this study will not be shared, sold, or used for fundraising purposes. Survey data and findings will be used only in an aggregate form for the express purposes of fulfilling the data needs of the outcome assessment. Responses to this survey are voluntary.

Public reporting burden for this collection of information is estimated to average twenty-five (25) minutes to respond to this survey, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An Agency may not conduct or sponsor, and respondents are not required to respond to, a collection of information unless it displays a valid OMB control number. Please send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to: A/ISS/DIR, U.S. Department of State, Washington, D.C. 20520.

I. GENERAL INFORMATION

1. Which organization provided your host/placement in the United States? Please check one box.

4-H Foundation (World Wise)
AFS-USA, Inc.
AIFS/AYA
American Councils
ASPECT Foundation
ASSE
AYUSA
CCI
CIEE
Nacel Open Door
PAX
PIE
World Link
Do Not Know

2. Exchange programs provide participants with many important opportunities for learning and engaging people from other countries. Please identify the three most important accomplishments of your program.

Increased my understanding of American society, people, and culture
Promoted mutual understanding between Americans and foreigners
Made friends with students from other countries
Made friends with American students
Improved my English
Improved my leadership skills
Improved my education
Gained opportunities to study in the United States
Gained skills to use to help my country when I return home
Shared my culture with others

3. How difficult was it for you to adapt to life in the United States?

	Very Difficult	Somewhat Difficult	Neither Easy Nor Difficult	Somewhat Easy	Very Easy
Adapting to life in the United States was…

II. PROGRAM SATISFACTION

4. What did you like best about your exchange experience? ______________________________________________________________ ______________________________________________________________ ______________________________________________________________

5. What did you like least about your exchange experience? ______________________________________________________________ ______________________________________________________________ ______________________________________________________________

6. Please rate your satisfaction with the following program components. Please check one box in each row.

	Very Dissatisfied	Dissatisfied	Neutral	Satisfied	Very Satisfied
Administration
Content
Variety of Experiences
Relevance of program to professional or educational development

7. Please rate your satisfaction with the specific program components of FLEX listed below. Please check one box in each row.

	Very Dissatisfied	Dissatisfied	Neither Satisfied Nor Dissatisfied	Satisfied	Very Satisfied
Pre-Departure orientation
Mid-year orientation
End-year orientation
Life with host family
FLEX program activities (for example: enhancement activities, workshops, community service)
Relationship with your local coordinator

8. If you were dissatisfied with any of the specific program components above, please explain why. ______________________________________________________________ ______________________________________________________________ ______________________________________________________________

9. How helpful was your local coordinator in the United States with the following items? Please check one box in each row.

	Not Very Helpful	Somewhat Helpful	Very Helpful	We Were Not In Touch
Answering any questions you had
Coordinating program activities
Finding a host family
Overall support

10. How useful were the following experiences during the program? Please check one box in each row.

	Not At All Useful	Somewhat Useful	Very Useful
Immersion into American daily life through living with a host family
Opportunities to share cultures with each other
Opportunity to practice English with native speakers
Participation in volunteer work/community service

11. Please elaborate on why the experiences listed above were either useful or not useful. ______________________________________________________________ ______________________________________________________________ ______________________________________________________________

III. ACTIVITIES AND EXPERIENCES IN THE U.S.

12. In the past year, how often were you involved in the following activities? Please check one box in each row.

	Never	Seldom	Some Of The Time	Most Of The Time
Community service (for example: helping others, environment, health, education)
Civic or political activism (for example: elections, volunteering)
Cultural activities (for example: visiting museums/historical sites, attending concerts, theater)
Family Activities
Religious activities
Sports teams
School clubs or organizations (for example: musicals, band, debate team)

13. Were you able to share information about your country in any of the following ways during your exchange? Please check one box in each row.

	Yes	No
Discussion with your host family, friends, or host community member
Formal presentation at a community event (for example: recreation center, home for elderly people, volunteering event)
Formal presentation at school
Formal presentation in a religious setting (for example: mosque, church, synagogue)
Interview with the media (for example: newspaper, radio, TV)

14. How much better do you think Americans’ understanding of your country is because of the information you shared with them?

	Not At All	Somewhat	A Good Deal	A Great Deal
Americans have better understanding of my home country

IV. CURRENT OUTLOOK AND OPINIONS

15. How do you view the United States Government and the American people? Please check one box in each row.

	Strongly Unfavorable	Generally Unfavorable	Neither Favorable Nor Unfavorable	Generally Favorable	Strongly Favorable
United States Government
American people

16. How did your views of the United States Government and the American people change as a result of your program participation? Please check one box in each row.

	Much Less Favorable	Less Favorable	No Change	More Favorable	Much More Favorable
United States Government
American people

17. How do you view the United States Government and its relationship with your home country?

	Strongly Disagree	Disagree	Neither Agree Nor Disagree	Agree	Strongly Agree
The United States Government is a trustworthy partner for my country

18. Please rate your understanding or knowledge of the following topics. Please check one box in each row.

	No Knowledge	Less Than Basic	Basic Knowledge	Beyond Basic	Advanced Knowledge
United States democracy
United States economy
United States values and culture
Religious and ethnic diversity in the United States
Freedom of speech and the press in the United States
Voluntary community service in the United States
Daily life in the United States

19. How much did participation in the program change your understanding or knowledge of the following topics? Please check one box in each row.

	No Change	Minimal Change	Moderate Change	Substantial Change
United States democracy
United States economy
American values and culture
Religious and ethnic diversity in the United States
Freedom of speech and the press in the United States
Voluntary community service in the United States
Daily life in the United States

20. Do you agree or disagree with the following statements? Please check one box in each row.

	Strongly Disagree	Somewhat Disagree	Neither Agree Nor Disagree	Somewhat Agree	Strongly Agree
Men and women should have equal opportunities
Men and women should equally share family responsibilities
Ethnic minorities should have equal opportunities
People with disabilities (mentally and or physically challenged) should have equal opportunities
Religious minorities should have equal opportunities

21. Do you agree or disagree with the following statements? Please check one box in each row. Individuals should have the right to…

	Strongly Disagree	Somewhat Disagree	Neither Agree Nor Disagree	Somewhat Agree	Strongly Agree
Travel freely to other countries
Have acceptable housing
Be considered equal under law regardless of age, gender, ethnicity or religion
Practice any religion
Receive an education
Have a job
Have acceptable health care
Have access to information
Have freedom of speech

22. Now that you have spent time in the United States, please indicate how strongly you agree or disagree with the following statement about Americans. Please check one box in each row.

	Strongly Disagree	Somewhat Disagree	Neither Agree Nor Disagree	Somewhat Agree	Strongly Agree
Most Americans are wealthy
Americans are friendly and open
Americans are well-informed about the world
Americans express their personal opinions, even if they contradict those of authorities

23. Please indicate how strongly you agree or disagree with the following statements about the United States. Please check one box in each row.

	Strongly Disagree	Somewhat Disagree	Neither Agree Nor Disagree	Somewhat Agree	Strongly Agree
The United States is a democracy that works well
The United States has laws and regulations that protect the individual
The United States economy provides a good living for its citizens
The United States foreign policy reflects the interests and attitudes of the American people

24. To what extent do you agree or disagree with the statements below? Please check one box in each row.

	Strongly Disagree	Disagree	Neither Agree Nor Disagree	Agree	Strongly Agree
Voting is important because real decisions are made in elections
Free and fair elections are the cornerstone of democracy
An independent media is important to the free flow of information
All citizens in a country should have equal rights and protections under the law, regardless of circumstances
The Rule of Law is fundamental to a functioning democracy
Individuals and organizations have the right to free speech and to voice opposition
Democratic principles enhance the workplace. Supervisors should incorporate democratic principles into their management practices

25. Please rate yourself on the following leadership characteristics. Please check one box in each row.

	Poor	Fair	Good	Excellent
Being self-reliant, being independent, relying on yourself
Speaking in public
Listening to other people's suggestions or concerns
Expressing ideas and feelings
Being tolerant of people different from you
Leading a team and motivating others
Being flexible
Solving problems
Discussing your beliefs/values
Willing to make changes in your community
Critical thinking
Using technology (Internet, computer applications)

V. PLANS

26. As a direct result of your participation in the exchange program, do you think you will do or receive any of the following in your community? Please check one box in each row.

	Yes	No
Assume a leadership role or position in your community
Establish a new organization in your community
Organize or initiate new activities or projects in your community

27. As a direct result of your participation in the exchange program, do you think you will do or receive any of the following at school/university? Please check one box in each row.

	Yes	No
Assume a leadership role or position at school/university
Establish a new organization at school/university
Organize or initiate new activities or projects at school/university

28. Do you think you will share your program experience or the knowledge you gained during your exchange in any of the following ways? Please check one box in each row.

	Yes	No
Participate in media interviews (newspaper, television, radio, Internet)
Give presentations to community, neighborhood, school, or university groups
Write newspaper articles, including editorials and opinion pieces
Write academic books
Write non-academic books
Write academic articles - for journals or academic publications

29. Upon returning home, do you plan to do any of the following? Please check one box in each row.

	Yes	No
Participate in FLEX alumni activities
Share your experience by creating a website
Share your experience through informal discussions with family, friends, or other community member back home
Share your experience by posting on a Blog or other Internet networking space (for example: MySpace, Facebook)
Support economic rights and social justice in your community
Volunteer in your community

30. Do you think you will remain in contact with people you met during your exchange program?

Yes
No

31. Of the following people you met during your visit to the United States, whom do you think you will keep in contact with once you return home? Please check all boxes that apply.

American classmates and friends
Host/placement organization staff
My host family
Other community members I met
Other FLEX participants
Teachers at my school

32. Would you recommend the FLEX program to others?

Yes
No

33. How would you improve the FLEX program? ______________________________________________________________ ______________________________________________________________ ______________________________________________________________

VI. PERSONAL BACKGROUND

34. Home country: [Drop-down list]

35. Which best describes the geographic location where you live. Please check one box.

My country's capital city
Another major city in my country other than the capital
A small city, town, or rural location in my country

36. Age: [Drop-down list]

37. Gender:

Female
Male

38. Do you know about the State Department Alumni website, https://alumni.state.gov? Please check one box.

Yes
No

39. Have you registered for the State Department Alumni website, https://alumni.state.gov? Please check one box.

I have registered
I have not yet registered
I do not plan to register

40. Thank you for completing this survey! If you have any additional comments you would like to make, please do so here. We value your thoughts. ______________________________________________________________ ______________________________________________________________ ______________________________________________________________

41. How long did it take you to complete this survey?  ________ Minutes

1 SV 2010-0024

OMB No.: 1405-0158

Expiration Date: 04/30/2011

Estimated Burden Time: 25 minutes