NC Home Language Survey
Parents/Guardians of all students entering a North Carolina public school are required to complete this form at the time of enrollment and record all information.
Student LAST name *
Your answer
Student FIRST name *
Your answer
Country of birth *
Your answer
Current School *
Date of birth *
MM
/
DD
/
YYYY
Current grade level *
What is the first language the student learned to speak? *
Your answer
What language does the student speak most often? *
Your answer
What language is most often spoken in the home? *
Your answer
Your name and relationship to student *
Your answer
Submit
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