RETURN TO MAIN SCHOOL FORMS PAGE/REGRESAR A LA PÁGINA PRINCIPAL

HOME LANGUAGE SURVEY

Date: ________________________

Teacher: ____________________

School: _____________________

It is a legal requirement that schools determine the language(s) spoken at home by each student. This information is essential in order for schools to provide meaningful instruction for all students.

Your cooperation in helping us meet this important requirement is requested. Please answer the following questions and return this form to your child's teacher. Thank you for your help.

Student's Name: ____________________________________________________________ (Last) (First) (Second or Middle)

Grade: ______________ Age: _____________

1. What language did your child learn to speak when he/she first began to talk? _____________
2. What language does your child most frequently speak at home? ___________________
3. What language do you speak most frequently when you talk with your child? ______________
4. What language is spoken most frequently by the adults at home? _______________________

_____________________________ Parent/Guardian's Signature