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    English HLS Updated Field

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    English HLS Updated Field

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    English HLS updated Field

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    English HLS updated Field

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    English HLS updated Field

    Copyright:

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    10 views2 pages

    English HLS Updated Field

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    of 2

    Home Language Survey

    Commissioner Mike Morath


    1701 North Congress Avenue • Austin, Texas 78701-1494 • 512 463-9734 • 512 436-9838 FAX • tea.texas.gov

    Student Name: Sanika Kotekar


    ________________________ District Name: Prosper
    __________________________
    Student ID#: ________________________ Campus Name: Walnut Grove
    __________________________

    HOME LANGUAGE SURVEY


    19 TAC Chapter 89, Subchapter BB, §89.1215
    (Home Language Survey only administered during initial enrollment in Texas public schools)

    To be completed by Parent or Guardian for students enrolling in Prekindergarten* through grade 8 (or
    by students in grades 9-12).

    * Prekindergarten includes any student enrolling in a 3- or 4-year-old school program.

    Part One:
    The state of Texas requires that the following information be completed for each student who
    enrolls in a Texas public school for the first time. It is the responsibility of the parent or guardian,
    not the school, to provide the language information requested by the questions below.

    Dear Parent or Guardian:


    Please answer the questions below about the languages your child or family uses. If your
    responses indicate the use of a language other than English, the school will conduct a
    language proficiency assessment to determine how well your child communicates in English.
    This information will be used to determine any appropriate linguistic supports and inform
    instructional recommendations. If you have questions about the purpose and use of the Home
    Language Survey, or you would like assistance in completing the form, please contact your
    school/district personnel.
    This survey shall be kept in each student’s permanent record folder. A copy of this survey shall
    follow the student while enrolled in any public or open enrolled charter school in Texas.

    January 2024 Page 3


    Home Language Survey
    Commissioner Mike Morath
    1701 North Congress Avenue • Austin, Texas 78701-1494 • 512 463-9734 • 512 436-9838 FAX • tea.texas.gov

    Part Two:
    Please answer the questions to the best of your ability.

    English, Hindi
    1. Which languages are used at home? ________________________________
    English, Hindi
    2. Which languages are used by the child at home? ________________________________
    3. If the child had a previous home setting, which languages were used? If there was no previous
    N/A
    home setting, answer Not Applicable (N/A). ________________________________

    ☐■
    By checking this box, I understand a request to correct an error to this Home Language
    Survey can only happen if:

    1) my child has not yet been assessed for English proficiency; and
    2) corrections are made within two calendar weeks of my child’s enrollment date.

    Note: Please contact your school about the benefits of bilingual education services. The
    following resources may also provide information on program services that foster bilingualism.

    • Parent/ Guardian Rights


    • Bilingual Education Program
    • Program Information Videos

    Please visit the Emergent Bilingual Support Portal (txel.org) for additional information.

    Poonam Kotekar 04/05/24


    Signature of Parent/Guardian ________________________________ Date _________________
    Sanika Kotekar
    Signature of Student if Grades 9-12 ___________________________ 04/05/24
    Date _________________

    January 2024 Page 4

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