Home Language Survey

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Surveys

Home Language Survey

Purpose of the Home Language Survey

This form is used to gather information about the languages spoken by the student and their family. The information helps the school provide appropriate educational services, including language support, to ensure the success of the student. Parents or guardians must complete this form as part of the enrollment process.

Please fill out student information below.

Student First Name: *

Student Last Name: *

Grade:

Please fill out parent or guardian information below.

Parent/Guardian Full Name: *

Parent/Guardian Phone Number: *

Parent/Guardian Email: *

Please answer the questions below.

What language(s) did your child first learn to speak? *

What language(s) does your child speak most often at home? *

What language(s) do you use most often when speaking to your child? *

Has your child received any formal education in a language other than English?

Yes

If yes, please specify the language(s).

Would you prefer to receive communication from the school in a language other than English?

Yes

If yes, please specify the preferred language.