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Introduction
Introduction and Consent: The Evaluation Division of the U.S. State Department's Bureau of Education
and Cultural Affairs would like to ask you a few questions about your knowledge, attitudes, and future
plans following your program experience as a Host community member. A host community member is an
individual, organization, or institution that sponsors, supports, or provides exchange programs support or
services. Host communities do not necessarily directly participate in a program. Benefits to this group
most often occur through interaction with the participants and/or alumni during or after the program.
Privacy Act Statement AUTHORITY: The information on this form is requested under the authority of 22
U.S.C. 2451 et seq (Mutual Educational and Cultural Exchange Act of 1961), P.L. 103-62 (Government
Performance and Results Act of 1993), and P.L. 111-352 (Government Performance and Results
Modernization Act of 2010).
PURPOSE: The purpose of gathering this information is to track program performance and the direction,
pace, and magnitude of change for ECA programs.
ROUTINE USES: The information on this form may be shared with members of Congress, and the Office
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of Management and Budget (OMB). De-identified data files may be shared (without Personally Identifiable
Information such as names or contact information) with ECA implementing partners and external
researchers who are assisting ECA in measuring its impact. More information on the Routine Uses for the
system can be found in the System of Records Notice State-08, Educational and Cultural Exchange
Program Records.
DISCLOSURE: Responding to this survey is voluntary. The answers you provide on the survey will have
no bearing on your participation in alumni activities or any future applications you may submit for U.S.
State Department programs.
By clicking “Consent and Enter Survey” button below, you are consenting to the above terms.
You can read ECA’s full data sharing and storage policy here: [LINK TO DATA POLICY]
Please complete this survey by [DEADLINE]. The survey has [NUMBER OF QUESTIONS] questions and
will take approximately [TIME ESTIMATE] minutes to complete. Thank you in advance for your time and
participation!
Contact [SUPPORT EMAIL] for technical support with the survey system or inquiries about specific
questions in this survey.
Consent and Enter Survey
Decline
Demographics
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Please confirm the program name, the last year you engaged with the program, and if there was a
reciprocal exchange. A reciprocal exchange is if you went abroad after an individual from another country
visit your home, school, or workplace, as part of a Department of State ECA program.
Program Name
Year
Reciprocal
Exchange?
Yes
No
Program
1
Program
2
Program
3
Program
4
Please select the option that best describes your gender.
Male
Female
Non-binary
I do not wish to respond
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Please select your age.
Are you an American or foreign host community member?
American host community member
Foreign host community member
What is your race or ethnicity? Select all that apply.
White
Black or African American
Asian
American Indian or Alaskan Native
Native Hawaiian or Other Pacific Islander
Are you Hispanic or Latino?
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No, not Hispanic or Latino
Yes, Hispanic or Latino
Please select your home state.
Please select the country where you engaged with the ECA participant.
Please select your host community member type.
Individual
Organization
U.S. Higher Education Institution
Cross-Cultural Competency
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Please indicate the extent to which you agree or disagree with the following
statements:
Strongly
agree
Agree
Neutral
Disagree
Strongly
disagree
Don't
know/Can't
ascertain
My/our organization's
understanding of how
various cultures of this
world interact has
increased
I/our organization is
better able to discuss
cultural differences from
an informed perspective
I/our organization is
more likely to consider
different cultural
perspectives when
evaluating global and
local problems
My ability to differentiate
between similar cultures
has NOT improved
I/our organization is
more aware of how my
own culture influences
how I see people from
other countries
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Strongly
agree
Agree
Neutral
Disagree
Strongly
disagree
Don't
know/Can't
ascertain
In situations where I/our
organization must deal
with cultural differences,
my comfort level has
increased
Our organization feels
more comfortable
explaining our values to
people from other
countries
Please select which interactions with individuals from other countries that most closely describe your
experience prior to hosting a program participant. Select all that apply.
I had never met someone from another country
I had briefly interacted with a few individuals from another country that were visiting or living in my country
I had studied, volunteered, or worked in another country
I had previously hosted someone from another country
I traveled to other countries frequently for work or recreation
I worked closely with people from other countries at my job
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My time engaging with the program(s) allowed opportunities for cultural connectedness. For example,
conversations about each other's countries, attending cultural events, etc.
Yes
No
I learned about another culture from an ECA participant or alumnus.
Yes
No
How have your views of other cultures changed as a result of your interactions with ECA program
participants and/or alumni?
Less favorable
No change - my view remained unfavorable throughout
No change - my view reaming favorable throughout
More favorable
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Networking
Are you still in contact with the exchange participant(s) you met during their program?
Yes
No
How many ECA exchange participants are you still in contact with?
Capacity Building
As a result of ECA programming that took place in my community, I have gained new skills, abilities, or
knowledge.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
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As a result of ECA programming that took place in my community, I have increased my skill level in a
language other than my native language.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Economic Development
Has your organization experienced an increase in collaborations as a result of engaging with an ECA
exchange? A collaboration is a continuous cooperation between individuals/organizations/institutions in
order to produce or create something or complete a task or achieve a goal.
Yes
No
Don't know
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What type of organizations have you established these collaborations with? Select all that apply.
K-12 School
Government Agencies
Colleges/Universities
Non-Government Organizations
Business
Other
Has your organization created any formal partnerships as a result of engaging with an ECA exchange
program? A partnership is a formal agreement of assistance, cooperation, or understanding among
institutions involved in ECA programming.
Yes
No
Don't know
Please select which types of organizations you have partnered with and provide the number of
partnerships.
Organization Type
Number of Partnerships
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Select
Organization
all that Type
apply
Number of Partnerships
Select all that apply
K-12 School
Colleges/Universities
Business
Government Agencies
Non-Government Organizations
Individuals
Please indicate the extent to which you agree or disagree with the following
statements:
Strongly
agree
Agree
Neutral
Disagree
Strongly
disagree
Don't
know/Can't
ascertain
My co-workers and
colleagues have
learned a great deal
about other countries
and cultures through my
involvement in
international visitor
programs
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Strongly
agree
Agree
Neutral
Disagree
Strongly
disagree
Don't
know/Can't
ascertain
Exchange programs
provides me with unique
business opportunities
that I wouldn't have had
otherwise
Our organization has
NOT gained new
insights regarding best
practices that we may
use
ECA exchange
participants benefit the
local economy
How many participants were employed by your business this year? Please enter numbers only.
Number of participants employed
Within the last year, has your organization changed strategies, processes, procedures, technologies, or
culture as a result of an exchange experience?
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Yes
No
Organizational Development
Which best describes your institution's approach to international partnerships in the past 12 months?
We have begun international partnerships for the first time
We have expanded the number of partnerships
We have moved toward fewer partnerships
The number of partnerships has remained about the same
Not applicable/have no partnerships
With whom does your institution partner abroad? Select all that apply.
Academic institutions
Foreign governments
Non-governmental organizations
Corporations
Other
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In what countries is your organization active in terms of its existing partnerships? Select all that
apply. To select options in a row, click and drag your mouse, or hold down Shift when selecting. To select
non-sequential options, hold down Ctrl (on a PC) or Cmd (on a Mac) when clicking.
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
In the last 12 months, has your institution increased, maintained, or decreased its efforts to recruit
international students?
Increased
Maintained
Decreased
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How has your institution expanded its efforts to recruit international students in the last 12 months?
Select all that apply.
Attending and participating in international education fairs and recruitment events
Providing professional staff specifically for international student recruitment
Engaging international alumni for recruitment
Online marketing and social media
Partnering with other organizations
Through scholarships, fellowships, stipends or other financial aid
Engagement of overseas student recruiters (agents)
Other
In the last 12 months, has your institution increased, maintained, or decreased its efforts to retain
international students?
Increased
Maintained
Decreased
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In the last 12 months, how has your institution increased efforts to retain international students. Select all
that apply.
Individualized academic support services
Orientation to the United States and local community
Orientation to the institution and/or U.S. classroom
Institutional advisory committee of international students
English-as-a-second-language (ESL) support for matriculated students
International student office
Financial Aid
Health Services
Immigration Support (e.g., support with visas, work permits, tax laws)
Other
Was your institution able to create or expand on study abroad exchange partnerships with support from
ECA?
Yes
No
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Since the conclusion of ECA support, which best describes your institution's approach to study
abroad/exchange partnerships?
We have expanded the number of partnerships
We have moved toward fewer partnerships
We have maintained our existing partnerships
To the best of your knowledge, did the number of students from your institution
who participated in the following types of education abroad experiences (for credit
or not for credit) increase, decrease, or remain the same in the lat 12 months?
Increase
Decrease
Remain the same
Study abroad
International internships
Service opportunities
abroad
Research abroad
Does your institution have a formal strategic plan for creating, expanding, or diversifying study abroad
plans for the institution as a whole, and/or for any of its schools/colleges?
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Yes
No
Does this strategic plan include specific enrollment targets (i.e., number of students)? If your institution
has multiple written pages, please indicate the focus of the institution-level plan, or that of the largest
school/college.
Yes, for the undergraduate level only, because we don't offer graduate programs
Yes, for graduate level only, because we don't offer undergraduate programs
Yes, for both undergraduate and graduate programs
Yes, for undergraduate, but not graduate level
Yes, for graduate, but not undergraduate level
No
OMB Control Number: 1405-XXXX
Burden Es mate: 20 minutes
Expira on Date: XX-XX-XXXX
PRA Statement
Public repor ng burden for this collec on of informa on is es mated to average 20 minutes per
response, including me required for searching exis ng data sources, gathering the necessary
documenta on, providing the informa on and/or documents required, and reviewing the final
collec on. You do not have to supply this informa on unless this collec on displays a currently valid
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OMB control number. If you have comments on the accuracy of this burden es mate and/or
recommenda ons for reducing it, please send them to: ecaevalua on@state.gov.
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File Type | application/pdf |
File Modified | 2020-08-07 |
File Created | 2020-08-07 |