Language Use Survey

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:إذا كنت ترغب في قراءة هذه المعلومات بلغتك الأم ، فيرجى استخدام الإرشادات التالية

The State of Oregon honors the language and culture of its people and respects the over 166 languages in our schools, and recognizes that:

Language is a key component of each person’s cultural identity,
Heritage and primary languages are instrumental in student academic and cultural success, and
Students who are multilingual/multicultural may have an advantage over students with a single language and are valued in career placements.

The purpose of the Language Use Survey is to help the school determine if your child qualifies for additional Title III supports in language instruction for English learners.

An English Learner is defined as a student:

Who was not born in the United States or whose native language is a language other than English
Whose native language is a language other than English, and who comes from an environment where a language other than English is dominant
Whose difficulties in speaking, reading, writing, or understanding the English language may impact the student’s ability to successfully achieve in classrooms where the language of instruction is English.
- — (ESEA Section 8101(20)

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Student's First Name: *

Student's Last Name: *

Student's School: *

Grade: *

Parent/Guardian First Name: *

Parent/Guardian Last Name: *

Parent/Guardian Phone Number: *

Parent/Guardian Email Address:

Communication Preferences

This question helps the school provide an interpreter or translated documents, free of charge, should you want them.

This section is for informational purposes only. It is not used to identify your child for English language proficiency placement testing.

What language(s) would you prefer the school use to communicate with you? *

Eligibility for Language Development Support

This section helps the school identify if your child should be assessed to receive support in academic English instruction.

This section is used to identify your child for English Language Proficiency placement testing. A response other than English to questions #2, #3, and/or #4 may qualify your child for English language proficiency placement testing.

What is the primary language used to communicate in your home? *

Other Primary Language: *

What language did your child learn first? *

Other First Language: *

What language is most often used by your child at home? *

Other Home Language: *

A 'Recent Arriver' is defined as a student who:

Is aged 3-21
Was NOT born in any US State (or US Territory, i.e. Puerto Rico, Guam, etc);
Has NOT been attending one or more schools in any one or more state for more than three full (cumulative) academic years.

Is your child a "recent arriver" as defined above? *

Does your child come from a home where a language other than English is spoken and entered a school in the US after Grade 2?

Is your child an immigrant who entered a school in the United States after Grade 2?

Does your child meet any of the following conditions?

Check all that apply.

My child has had at least two year less schooling that their peers

My child is at least two years below expected grade level in reading and math

My child is pre-literate in their native language

Language Use Survey

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