Preschool Home Language Survey Parent/Guardian Questionnaire

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Please Enter the child's first name (Required.)

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Please enter the child's last name (Required.)

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Please enter the child's middle name

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Please enter the child's date of birth (Required.)

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Person completing the survey (Required.)

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What language did the child learn when he/she first began to talk? (Required.)

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What language does the family speak at home most of the time? (Required.)

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What language (s) does the primary caregiver (s) speak to the child most of the time? (Required.)

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What language (s) does the child speak to his/her primary caregiver (s) most of the time? (Required.)

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What language (s) does the child speak to his/her brothers and sisters most of the time? (Required.)

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What language does the child speak to his/her friends most of the time? (Required.)

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Please list any preschool program(s) your child attended before coming to our program or indicate none if not prior programs have been attended by the child: (Required.)

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In which language do you wish to receive information from the school? (Required.)

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What name do you use for your child (if different from above)?

Please enter this confirmation code in your OnCourse Registration form: f69lv
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