Scribd Logo
Upload

Welcome to Scribd!

  • 35 views

    Hls Survey English

    Uploaded by

    api-353834899
    This document is an educational history and home language survey for a student. It collects information such as the student's country of birth, entry date to the US, years of school attendance, primary home language, and whether they have participated in ELL/ESL programs. The parent or guardian must sign and date the form, with one copy going to the school, ELL department, and student's cumulative file.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Hls Survey English

    Uploaded by

    api-353834899
    35 views1 page
    This document is an educational history and home language survey for a student. It collects information such as the student's country of birth, entry date to the US, years of school attendance, primary home language, and whether they have participated in ELL/ESL programs. The parent or guardian must sign and date the form, with one copy going to the school, ELL department, and student's cumulative file.

    Original Title

    hls survey english

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document is an educational history and home language survey for a student. It collects information such as the student's country of birth, entry date to the US, years of school attendance, primary home language, and whether they have participated in ELL/ESL programs. The parent or guardian must sign and date the form, with one copy going to the school, ELL department, and student's cumulative file.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    35 views1 page

    Hls Survey English

    Uploaded by

    api-353834899
    This document is an educational history and home language survey for a student. It collects information such as the student's country of birth, entry date to the US, years of school attendance, primary home language, and whether they have participated in ELL/ESL programs. The parent or guardian must sign and date the form, with one copy going to the school, ELL department, and student's cumulative file.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    10435 Downsville Pike

    Hagerstown, MD 21740
    301-766-2800

    Please respond
    Educational History and Home Language Survey (English)
    (The information on this form will be used to complete state and federal reports and improve services for your student)
    in English.

    Students Name
    First Name Middle Name Last Name

    Date of Birth School Grade

    1) What is the students country of birth?

    2) If born outside the USA, what is the students most recent entry date
    to the USA (excluding visits/vacations)?

    3) How many total years has the student attended school?

    4) Since entering school, has the student ever missed more than six
    consecutive months of formal schooling? Yes No

    5) How many years has the student attended U.S. schools?

    6) On what date the student first enroll in a US school?

    7) What language did the student learn when he/she first began to talk?

    Can the student read and write this language? Yes No

    8) What language does the student most frequently use at home?


    Mother:
    9) What language do you most frequently speak to the student at Father:
    home? Guardian:

    10) Has the student ever been in an ELL/ESL/ESOL or a bilingual


    program? Yes No

    If so, how many years did the student attend the program?

    If available, in what language would you prefer to receive communication from the
    school?

    Parent or Guardian Signature Date

    Please distribute one copy to each:


    Building a Community That Inspires Curiosity,
    ELL School-based MemberCreativity, and Achievement.
    ELL Department Central Office Students Cumulative File

    www.wcps.k12.md.us

    You might also like