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C. Understands the home language and English equally. D. E. Date OFFICE USE ONLY Student ID Date Distributed 00NCLB-B1 Rev. 04/13 - IA Date Received 2013 TransACT Communications Inc. 248630. Southeast Polk Community Schools HOME LANGUAGE SURVEY Student Name Birth Date Sex Male Female Parent/Guardian Name Address Home Telephone Work Telephone School Grade Date Was your child born in the United States Yes No If yes in which state If no in what other country Has your child attended any...
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