Home Language Survey
The U.S. Office of Civil Rights requires schools to identify possible English Learner (EL) students during enrollment.  This Home Language Survey (HLS) is used as a tool to determine if your child(ren) is/are eligible for language support services.  If a language other than English is used by you or your child(ren) and your child(ren) meets the English Learner (EL) definition, the school may give your child(ren) an English Language Proficiency Assessment.  The school will share the results of the assessment with you.


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Name of the person filling out this form *
Relationship to the child(ren) referred to in this form. *
What language(s) are spoken at home? *
What language(s) do you use the most to speak to your child(ren)? *
What language(s) do your child(ren) use the most at home? *
What language(s) did your child(ren) learn when he/she first began to talk? *
List other language(s) that your child(ren) used with a grandparent or caretaker: *
If available, what language do you prefer to receive information from the school?
Has your child(ren) ever been in an English as a Second Language (ESL or EL) Program? *
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