Warren County School System Home Language Identification Survey The native or home language of each student must be recorded in his/her permanent record. A. Please ask each student the following four (4) questions about his/her language background. Circle or write in your answer. 1. What was the first language your child learned to speak? English Spanish Other___________________________ 2. What language does your child speak most often outside of school? English Spanish Other___________________________ 3. What language do people usually speak in your child’s home? English Spanish Other___________________________ 4. In what language do you want notices sent to you from the school? English Spanish Other___________________________ If any of the above four questions have been answered with a language other than English, please fill out section B. B. Student Information Student Name:______________________________ Grade/Section:_______ Sex::______ Address:_________________________________________________________________ Street City/State Zip Code Date of Birth:__________________ Place of Birth:_______________________________ Date this student entered U.S.:____________________ School(WCSS):_______________ Is this student an immigrant? Yes No Is this student a refugee? Yes No Do parents/guardians speak and understand English? Yes No If no, what language do they speak?___________________________________________ In your opinion, does this student need English as a Second Language Instruction? Yes No Lau (Language Assessment Use) Category of Student _____ Category A- speaks only the language other than English _____ Category B- speaks mostly the language other than English _____ Category C- speaks English and the other language equally well _____ Category D- speaks mostly English _____ Category E- speaks only English ____________________________ ____________________________ Signature of Parent/Guardian/Student Signature of Questioner Original goes to student’s permanent record; copy to central office Home Language Survey Summary The following summary outlines how the home language survey is used in Warren County and how the survey has been redesigned to meet the needs of the Warren County Schools staff as well as adhering to the Tennessee State Board of Education Policy. The home language survey is administered to every student enrolling in school for the first time. The survey should be administered at the time of entrance in school by a staff member of the ESL department. The survey must contain three basic questions; 1. What is the first language your child learned to speak? 2. What language does your child speak most often outside of school? 3. What language do people usually speak in your child’s home? These questions are required questions that the English as a Second Language (ESL) Program Policy dictates from the State Board of Education which was passed on first reading January 28, 2005. The other questions on the form are for ESL staff and will be used to aid school staff in properly serving both students and families in receiving the best education they can possibly obtain. I redesigned the survey to reflect the language in the state board policy to be prepared for the policy to go into effect on passage of final reading April 15, 2005. If the answer to any of the above questions is anything other than English the student will be classified as NELB Non-English Language Background and will be tested for English proficiency. In the second step of the process NELB students must provide documentation from a previously attended school of meeting the definition of fluent English proficient. If the student is not determined proficient in English by either English language proficiency test or by documentation by another school then the student is determined to be limited English proficient and is identified as an English language learner (ELL) and is required to receive ESL services.
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