Home Language Survey - Torchlight Academy

Student Name*

Enter your full name

Date of Birth*

Grade

North Carolina state law asks every school to determine what language is spoken at the house of every student. We ask for your cooperation to help us follow this important requirement. Please answer the following questions regarding your child.

1. What is the first language the student learned to speak?*

2. What language does the student speak most often?*

3. What language is most often spoken in the home?*

4. What language do you most frequently use to speak to your child?*

If the answer for any of the 4 questions above is any other language than English, it is possible that your child qualifies for English as a second language (ESL) services.

Would you like for us to consider your child for this service?*

New Resident: What date did your child first enroll in any school in the United States? (Month/Year)

Parent/Guardian Name*

Today's date*