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Home and Language Survey
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Additional Pages:
Assessment of English Language Proficiency
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Home and Language Survey
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Identification of LEP

A three-question home language survey (Option A-located on the registration form or Option B-Appendix Form A) is completed by every student when initially registering in the district to determine if there is the influence of a language other than English. This survey will identify any languages other than English that are:

  • First learned or acquired by the student.
  • Used by the student in the home.
  • Used by the student outside of school.

If the primary language is other than English, school personnel will work with the parents to complete the Language Minority Student Educational Profile (Appendix Form B). This interview collects background data on the student to assist in determining the identification of an LEP student. At this time school personnel will explain the ESOL program to the family, either through a translated description or an interpreter.

Using the information obtained from the survey (Option A-located on the registration form or Option B-Appendix Form A) and the information from the Language Minority Student Educational Profile (See Appendix Form B), the designated school staff member will schedule testing.

Home Language Survey

Language Background

Student's Country of Birth ___________  If not the U.S., what date did the student first enter any U.S. school?     _________________

a.  Is language other than English used in the home?  Yes______  No______

b.  Did student have a first language other than English?  Yes______  No______

c.  Does the student speak a language other than English most of the time?  Yes______  No______

d.  If YES to any of the above, what is the language? ____________________________

Douglas County School System • 9030 Highway 5, Douglasville, GA 30134 • Phone: (770) 651-2000 Copyright © 2018 Douglas County School System SCHOOLinSITES