HOME LANGUAGE SURVEY. What language did your son/daughter learn when s/he first began to talk? What language does your son/daughter most frequently use at home? What language do you use most frequently when speaking to your son/daughter? What language is most frequently spoken by the adults at home?
HOME LANGUAGE SURVEY. Q- #1 What was the first language used by the student? Q- #2 At home, does the student hear or use a language other than English more than half of the time? Yes or No Q- #3 Does the student understand a language other than English? Yes or No Q- #4 When interacting with his/her parents or guardians, does this student use a language other than English more than half of the time? Yes or No Q- #5 When interacting with caregivers other than his/her parents or guardians, does the student use a language other than English more than half of the time? Yes or No Q- #6 Has the student recently moved from another school district where he/she was identified as an English language learner? Yes or No List home language(s) spoken: El nombre del niño(a): Encuesta sobre el idioma del hogar Q- #1 Cuál fue el primer idioma usado por el estudiante? Q- #2 En la casa, el estudiante oye or usa otro lenguaje que no sea inglés más de mitad del tiempo? Si o No Q- #3 El estudiante puede entender otro idioma además del inglés? Si o No Q- #4 Cuando teniendo interacciones con sus padres o guardianes, el estudiante usa otro lenguaje que no sea inglés más de mitad del tiempo? Si o No Q- #5 Cuando teniendo interacciones con sus cuidadores que no xxxx sus padres, el estudiante usa otro lenguaje que no sea inglés más de mitad del tiempo?Si o No Q- #6 ¿Se ha mudado recientemente el estudiante de otro distrito escolar donde estaba identificado como estudiante de inglés? Si o No
HOME LANGUAGE SURVEY. What language did your son/daughter learn when s/he first began to talk? What language does your son/daughter most frequently use at home? What language do you use most frequently when speaking to your son/daughter? What language is most frequently spoken by the adults at home? 8) EMERGENCY INFORMATION: Name of Contact Phone # _Relationship Name of Contact Phone # _Relationship Name of Physician Phone # City: Insurance Company Policy and/or Medi-Cal # _ Conditions which might lead to health problems (allergies, seizures, asthma etc): _ List any restrictions or medications taken: _ Authorization for Emergency treatment of a minor In Case of sudden illness or injury to your son/daughter, every effort will be made by school officials to contact you, your family physician or the person named by you above to be called in an emergency. If it is impossible to reach you, your signature above will assure emergency treatment by authorized medical and/or hospital personnel. I (We) the undersigned parent(s)/legal guardian of the above named minor, do hereby authorize the Orange County Department of Education and its employees as agents for the undersigned to consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment, and hospital care which is deemed advisable by, and is to be rendered under the general or specific supervision of any physician and surgeon licensed under the provisions of the Medical Practice Act on the medical staff of a licensed hospital no matter where such service is rendered. The agent for the undersigned and its employees are released of any civil of financial liabilities for the aforementioned diagnosis, treatment, hospital care, or any other acts performed that reasonable and necessary for the welfare of the minor. This authorization is given pursuant to the provisions of Section 25.8 of the Civil Code of California. This authorization shall remain effective unless revoked in writing and delivered to said agent. The signatures below indicate understanding and acceptance of information listed above. Parent Signature: _ Date: _ Student Signature: _ Date: _ Orange County Department Of Education Division of Alternative Education Alternative, Community, and Correctional Education Schools and Services STUDENT REGISTRATION FORM Please Print Clearly Legal Name: Last First MiddleA Prior ACCESS student: -No -Yes, If yes, has your name changed from a prior enrollment: -No -Yes If yes, indicate name used in the prior enrollmen...
HOME LANGUAGE SURVEY. A Delaware education policy requires schools to determine the language(s) spoken at home by each student. Your cooperation in helping us meet this important requirement is requested. Thank you for your help. • Which language did your child learn when he/she first began to talk? • What language does your child most frequently use at home? • What language do you use most frequently to speak to your child? • What language is most often spoken by the adults at home? • If a language other than your own is spoken in school, does your child understand: 🞎Everything 🞎Most of what is said 🞎Some of what is said 🞎Very little of what is said 🞎Nothing 🞎N/A I verify all information presented on this form is factual. I understand that any misinformation regarding residency will result in the termination of this student’s enrollment in the Xxxxxx Xxxxxx School District. It is the responsibility of the parent/guardian to inform the school of any changes in information on this form. Signature: Date: Individual Enrolling Student Relationship to Student: Where Educational Excellence Is A Tradition
HOME LANGUAGE SURVEY. Q- #1 What was the first language used by the student? Q- #2 At home, does the student hear or use a language other than English more than half of the time? Yes No Q- #3 Does the student understand a language other than English? Yes No Q- #5 When interacting with his/her parents or guardians, does this student use a language other than English more than half of the time? When interacting with caregivers other than his/her parents or guardians, does the student use a language other than English more than half of the time? Yes No Yes No Has the student recently moved from another school district where he/she was identified as an English language learner? Yes No List home language(s) spoken: HILLSDALE PUBLIC SCHOOLS Proudly Charting a Course for Success NEW STUDENT COURSE SELECTION FORM Student's Name: Xxxxxx Xxxxx Middle School requires all middle school students to take four core classes: LA, Math, Social Studies and Science. Part A (all grades): Math Level Question {Grades 6-8) What math level class did you take in your last district (regular level or accelerated)? Part B (Grade 6-8 ONLY): World Language Options: Please check off ONE World Language option that your prefer. This is based on class availability. • Spanish • Italian If you did not take Spanish or Italian in your last district, what foreign language class did you take? Descriptions:
