CVSD Registration: Home Language Survey
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Home Language Survey 
Email *
Right to Translation and Interpretation Services: Indicate your language preference so we can provide an interpreter or translated documents, free of charge, when you need them.
Eligibility for Language Development Support: Information about the student’s language helps us identify students who qualify for support to develop the language skills necessary for success in school. Testing may be necessary to determine if language supports are needed.
Prior Education: Your responses about your child’s birth country and previous education: Give us information about the knowledge and skills your child is bringing to school. May enable the school district to receive additional federal funding to provide support to your child. This form is not used to identify students’ immigration status.
Student Last Name *
Student First Name *
Student Date of Birth *
Parent/Guardian Name *
Thank you for providing the information needed on the Home Language Survey. Contact your school district if you have further questions about this form or about services available at your child’s school. Parent/Guardian Signature (please type first & last name)
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