SCHOOL DISTRICT U-46
ELL EDUCATIONAL SERVICES

DUAL LANGUAGE EDUCATION PROGRAM INTEREST FORM
2015-2016 SCHOOL YEAR

This form is to be used only for students entering kindergarten or 1st grade in the 2015-2016 school year.

This form serves the purpose of identifying students whose parents wish for them to participate in the 80:20 Dual Language Program. In order to ensure that all applicants are considered, parents/legal guardians must submit this form in order to receive a SUBMISSION CONFIRMATION NUMBER. SUBMITTING THIS INTEREST FORM DOES NOT AUTOMATICALLY ENSURE YOUR CHILD’S ADMISSION INTO THE DUAL LANGUAGE PROGRAM.

INTEREST

I am interested in signing up for the Dual Language Program for my child starting the next School Year 2015-2016.*

STUDENT PERSONAL INFORMATION:

*
*
(MM/DD/YYYY)*

Gender:*


PARENT/GUARDIAN INFORMATION:*


*

*
*
*



STUDENT INFORMATION FORM
PART B

English

Home Language Survey

The state requires the district to collect a Home Language Survey for every new student. This information is used to count the students whose families speak a language other than English at home. It also helps to identify the students who need to be assessed for English language proficiency.

Is a language other than English spoken in your home?*
 
     
       
Does your child speak a language other than English?*
 
     

If the answer to either question is yes, the law requires the school to assess you child's English language proficiency.


By signing this 80:20 Dual Language Interest Form I give consent for my child to be accepted into the 80:20 Dual Language Program. Given the nature of the development of a second language, our family is committed to support our child for a period of at least six years. In addition, I am willing to sign the 80:20 Dual Language Parent Compact for School District U-46.


You have selected NO for your interest in the U-46 80:20 DL Program.

Is this correct?