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Parental Home Language Survey
Dear Parent/Guardian:

In order to provide your child with the best possible education, we need to determine how well s/he understands, speaks, reads and writes in English, as well as prior school and personal history.

Please complete the sections below for parental communication and language preferences. Your assistance in answering these questions is greatly appreciated. Thank you.

Best,
DPHHS Campus Registrar

Email address *
Full name of parent. *
1 point
Full name of scholar *
1 point
Q1. What is the preferred WRITTEN language of the scholar's MOTHER (enter only 1 language)? *
1 point
Q2. What is the preferred SPOKEN language of the scholar's MOTHER(enter only 1 language)? *
1 point
Q3. What is the preferred WRITTEN language of the scholar's FATHER (enter only 1 language)? *
1 point
Q4. What is the preferred SPOKEN language of the scholar's FATHER (enter only 1 language)? *
1 point
Q5. What is the preferred SPOKEN language of the FIRST CONTACT listed on your scholar’s Emergency Contact Card? A complete response provides the name, relationship to scholar and phone number of this contact. Enter only 1 language (E.G. Jane Doe - Family Friend, English; 123-456-7891) *
1 point
Q6. What is the preferred WRITTEN language of the FIRST CONTACT listed on your scholar’s Emergency Contact Card (enter only 1 language)? *
1 point
Q7. What is the preferred SPOKEN language of the SECOND CONTACT listed on your scholar’s Emergency Contact Card? A complete response provides the name, relationship to scholar and phone number of this contact. Enter only 1 language (E.G. John Doe - Brother, English; 123-456-7891) *
1 point
Q8. What is the preferred WRITTEN language of the SECOND CONTACT listed on your scholar’s Emergency Contact Card (enter only 1 language)? *
1 point
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