ࡱ> 9;87 bjbjUU ,7|7| l,,,,,,,``$^=<y Gi$4 TQ,^,, ,, Y,,  ``"`0$p@R,,,,STATE BOARD OF EDUCATION APPROVED HOME LANGUAGE SURVEY * The  FORMTEXT Name of School District is collecting information regarding the language background of each of its students. This information will be used by the district to determine the number of children who should be provided bilingual instruction according to Sections 380.1152 - 380.1157 of the School Code of 1995, Michigans Bilingual Education Law. Would you please help by providing the following information? Thank you very much for your cooperation. Name of Student  FORMTEXT       Grade  FORMTEXT       Age  FORMTEXT       School Building Is your childs native tongue a language other than English?  FORMCHECKBOX  Yes  FORMCHECKBOX  No What is that language?  FORMTEXT       Is the primary language1 used in your child s home or environment a language other than English?  FORMCHECKBOX  Yes  FORMCHECKBOX  No What is that language?  FORMTEXT       Signature of Parent or Guardian Address Date 1"Primary language means the dominant language used by a person for communication. * Translation of this survey form in Spanish, Arabic, French, Italian and Ojibwa is available at the Office of Field Services at 517-373-6066. ?BCMNOfgs>@`bvxz<`kȱwjrCJUjCJUj>*CJUj>*CJUmHnHuj>*CJUjCJUmHnHujCJU jCJUjUmHnHu>*CJmHnHuj>*CJUj>*CJU>*CJCJ."9:;:<>>@lm  `^ & F `@& ^ `jz/^ & F `^ Tl$%(/$a$  & ( < > @ J L !"jBCJUjCJUjZCJUjUmHnHuCJH*CJ<aJ<>*CJjCJUmHnHujCJUCJ jCJU% !u `P0*^ `$`'/ `jz/^ *00P= /!"#$%DText1Name of School DistricttDText2tDText3tDText4tDeCheck1tDeCheck2tDText5tDeCheck1tDeCheck2tDText5 i@@@ Normal1$7$8$H$_HaJmH sH tH <A@< Default Paragraph Font4&@4 Footnote ReferenceDOD Level 1# & F hp0@&^p`0  v "9:;lmfgh'(| 0000000000000 00m0m0m0m 00000000000    BNf0<BNZ`htz &, FtFtFtFtG G FtG G Ft8@ (  HB  C DHB  C DHB  C DB S  ? ]  t  + t~ + tText1Text2Text3Text4Check1Check2Text5C1Oi gCa{   gv ::Bg 0FKaccf{z{ ff:;BB{|   sittersonEJP:\Central Support\SittersonE\Bilingual\Languages\Home language survey.wpd sittersonE?P:\Central Support\Bilingual\Languages\Home language survey.wpd sittersonE?P:\Central Support\Bilingual\Languages\Home language survey.wpdMarshH?P:\Central Support\Bilingual\Languages\Home language survey.wpdMarshHIC:\Documents and Settings\MarshH\Desktop\for web\Home language survey.dotƙ*0^`0.0^`0CJOJQJ^JaJ.XOk\(=k>km Pk0.)k10?k2>k3x>k4 >k5=k6|=k7h