AXIS Home Language Survey

Home Language Survey

AXIS International Academy Elementary & Preschool
The Home Language Survey is required for NEW students enrolling for the first time at AXIS International Academy in grades Prekindergarten - 6th.

This form does not factor into partner language placement; it is solely for the purpose of determining eligibility for English Language Learner (ELL) academic supports.

For questions regarding this form, please contact AXIS International Academy Program Specialist Elisa Welch at ewelch@axiscolorado.org or 970-658-4199.
Name of Parent/Guardian Completing Survey*

First NameLast Name
Confirmation Email*
example@example.com
Student Language Information
Please answer the questions below accurately and completely. This information is necessary to provide the most appropriate placement and instruction for your child and will not be used for any other purposes.
Name of Student*

First NameLast Name
What is the primary language used in the home, regardless of the language spoken by the student?*
What is the language most often spoken by student?*
What is the language that the student first acquired?*
Signature
I certify that I am a parent or legal guardian of the student listed on this form, and that all the information I have provided is true and correct to the best of my knowledge.

Clear
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Home Language Survey