Home Language Survey (Revised March 2024)

Sudbury Public Schools Home Language Survey

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Massachusetts Department of Elementary and Secondary Education regulations require that all schools determine the language(s) spoken in each student's home in order to identify their specific language needs. This information is essential in order for schools to provide meaningful instruction for all students. If a language other than English is spoken in the home, the District is required to do a further assessment of your child. Please help us meet this important requirement by answering the following questions.

Thank you for your assistance.
Home Language Survey

Massachusetts Department of Elementary and Secondary Education
Name*

First Name(s)Middle NameLast Name(s)
Date of Birth:*

MonthDayYear
Anticipated Start date in Sudbury

MonthDayYear
The 2024-2025 school year starts on August 28, 2024.
Current Grade:*
What grade is your child in as of today if enrolled?
Gender:*

FMN
Country of Birth:*
Date first enrolled in ANY U.S. school:*
mm-dd-yyyy
How many years has the student been in US Schools? (Not including Preschool)*
For new kindergarteners, answer "0"
Name of Former School:*
Location of Former School (City, State, Country)*
What is the PRIMARY language used in the home regardless of the language spoken by the student?*
Please just enter ONE language
What language did your child FIRST learn to understand and speak? *
Please just enter ONE language
Which language do you use MOST with your child?*
Please just enter ONE language
What other language is spoken with your child? (Include grandparents, uncles, aunts and caregivers.)*
Language #1
How often is this language used?*

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If there is another language spoken with your child, please list it here.
Language #2
How often is this language used?

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If there is another language spoken with your child, please list it here.
Language #3
How often is this language used?

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Which language does your CHILD use?*
Language #1
How often is this language used?*

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If your child speaks another language, list it here.
Language #2
How often is this language used?

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If your child speaks another language, list it here.
Language #3
How often is this language used?

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Will you require written translations of information in a language other than English?*
If yes, what language?
Will you require an interpreter at Parent-Teacher meetings?*
If yes, what language?
Parent/Guardian Signature*
Your Signature (Type full name above.)
Additional Questions

Sudbury Public Schools
New Sudbury School:*

HaynesLoringNixonNoyesCurtisPreschoolUnknown
How many years has your child lived in the United States?*
What country is your language or dialect from? (for example: Brazilian Portuguese, Egyptian Arabic, Haitian Creole?)
Is there anything else you would like to tell us about your child's language?
Name of Person Completing Form:*

First NameLast Name
Email Address for Confirmation*
example@example.com
After submission, you will be redirected back to the Sudbury registration page. Thank you!
Should be Empty:

Home Language Survey

Additional Questions