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TWO REQUIREMETS BY Federal Law
When Identifying LEP Students
Chipola Institute
HOME LANGUAGE SURVEY
Academic Year 2024-2025
Dear Parent/Guardian,
Welcome To Our School Community! To Help Us Provide The Best Educational Experience For
Your Child, Please Complete This Home Language Survey. This Information Will Help Us Understand
Your Child's Language Background And Ensure Appropriate Academic Support. All Information Will
Remain Confidential And Will Only Be Used For Educational Purposes.
STUDENT INFORMATION
Full Name: ___________________________________ Date: _______________
Grade Level: _________________________________ DOB: _______________
Previous School(S): _______________________________________________
LANGUAGE BACKGROUND ASSESSMENT
Please Answer All Questions As Completely As Possible:
1. What Language(S) Did Your Child First Learn To Speak?
□ English □ Other (Please Specify): _______________________________
2. What Language(S) Are Spoken In Your Home Most Of The Time?
□ English □ Other (Please Specify): _______________________________
Primary Language: _____________ Secondary Language: _______________
TWO REQUIREMETS BY Federal Law
When Identifying LEP Students
Chipola Institute
HOME LANGUAGE SURVEY
Academic Year 2024-2025
Dear Parent/Guardian,
Welcome To Our School Community! To Help Us Provide The Best Educational Experience For
Your Child, Please Complete This Home Language Survey. This Information Will Help Us Understand
Your Child's Language Background And Ensure Appropriate Academic Support. All Information Will
Remain Confidential And Will Only Be Used For Educational Purposes.
STUDENT INFORMATION
Full Name: ___________________________________ Date: _______________
Grade Level: _________________________________ DOB: _______________
Previous School(S): _______________________________________________
LANGUAGE BACKGROUND ASSESSMENT
Please Answer All Questions As Completely As Possible:
1. What Language(S) Did Your Child First Learn To Speak?
□ English □ Other (Please Specify): _______________________________
2. What Language(S) Are Spoken In Your Home Most Of The Time?
□ English □ Other (Please Specify): _______________________________
Primary Language: _____________ Secondary Language: _______________
