THE SCHOOL DISTRICT OF GREENVILLE COUNTY
PRIMARY/HOME LANGUAGE IDENTIFICATION FORM
(Please Print)

   This form must be completed at registration for every student who registers in a district school for the first time. If the first language is other than English, contact the Foreign Language/Bilingual Consultant at the District Office (242-6450) or the Bilingual Education Office (235-0141) for assistance in placement before registering the student. If the first language is English, proceed with registration and file this form in the student's permanent record folder.

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                                Student's Name                                                                  Date

_______________________________________ ___________________________________
                              Student's Address                                                     Current Grade Level

_______________________________________ ___________________________________
           City,                   State,                     ZIP                                              County of Birth

_______________________________________  ___________________________________
                                 Name of School                                                  Alien Registration Number

    Please answer the following questions about the student's language/cultural background before completing the school registration form.

    What is the first language you (the student) learned to speak? (Circle the appropriate number)

Arabic Gujarati Spanish
Cambodian Hindi Tagalog
Chinese Japanese Thai
English Korean Urdu
French Laotian Vietnamese
German Portuguese Other______________
Greek

What is the language you (the student) speak most often?__________________________

What language is spoken most often in your home?_______________________________

Do your parents/guardians read and speak English?______________________________

            Mother                   yes____  no____
            Father                    yes____   no____
            Guardians             yes____   no____

Signature of person completing this form_______________________________________