Search to Involve Pilipino Americans
3200 West Temple Street Los Angeles, CA 90026
KULTURAL ENRICHMENT & LANGUAGE PROGRAM (KELP) Questionnaire
Has your child been through a KELP program before? YES ____ NO___ If yes, when? (e.g. Fall 2007) _________________________
Please mark the following boxes accordingly:
Does your child understand Tagalog? Does your child speak Tagalog? Can your child count in Tagalog Can your child recite the alphabet in Tagalog? Can your child sing songs in Tagalog? Can your child read or write in Tagalog?
NOT AT ALL
SOME
WELL
VERY WELL
YES Is English your child’s first language? Is Tagalog your child’s first language? YES Is Tagalog spoken at home? Does your child get exposed to Tagalog? If so, where/how? (circle one) Does your child know any other languages aside from English? If so, what language? Where were you born? Where were you raised? Has your child ever been to the Philippines? NO FREQ. SOMETIMES
NO
NEVER
Grandparents YES NO
Family
Mother: _____________ Father: ______________ Mother: _____________ Father: ______________ YES NO
What would you like your child to learn in this class? __________________________________
3200 West Temple Street
Los Angeles, CA 90026 Email: fnayani@esipa.org
Phone: 213-382-1819 Ext. 108 Website: http://www.esipa.org
Fax: 213-382-7445