CTE Primary Language Survey

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Based on “Primary Home Language Survey” (Vermont Department of Education)

First Name: *

Last Name: *

Date of Birth: *

YYYY

Gender: *

Country of Birth: *

Year of Entry in the U.S. (for foreign-born): *

The year you first went to any U.S. school (for foreign-born) *

What is the native language of each parent/guardian? *

What language(s) are spoken in your home? *

Which language did you learn first? *

Which language(s) do you use most frequently at home? *

What other languages do you know? *

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