6141.311 Appendix B

Recommended Script for HLS Administrators to Use When Administering the HLS

Before administering the HLS, the HLS administrator must determine the parent's language of choice for completing it. If the parent does not complete the form in English, he/she must have access to the form, or an oral interpretation, in a language they can understand. Once the language has been determined, the following script should be used, in that parent's language.

Welcome to our school!

We have a few questions about languages spoken at home. We are required by the US Department of Education to ask for this information because it will help us know how we can best support your child. The language information also helps us know how we can best communicate with you. Please share with us about the language(s) spoken by your family and in your home.

Please complete this form and return it to the school office as soon as possible. If you have questions or need help with the form, I will do my best to answer your questions. If you still have questions after we speak, please contact: [district contact here].

•  Write your child's first name, then last name. _____________________________________

•  Write your child's date of birth. ________________________________________________

Now the form is going to ask you questions about the languages your child speaks and understands. The answers to the questions will help us know how we can best support your child. Please answer each one.

1)  What is the primary language used in the home, regardless of the language spoken by the student?
__________________________________________________________________

2)   What is the language most often spoken by the student? ____________________________

3)   What is the language that the student first acquired? _______________________________

Please print your name, then sign and date the form. Someone here in the office will review the form and will let you know about the next steps in your child's registration process. If needed, an English language specialist may meet with you and your child to describe the next steps in the process, which can include an interview and an assessment of your child's English proficiency. All of this will help us find the best support for your child, and we will describe all the options to you to make sure you understand.

Parent/guardian name (please print)

_____________________________                          ________________________
Parent/guardian signature                                               Date