CIMARRON MUNICIPAL SCHOOLS
A Legacy of Excellence
Board of Education
Valorie Garcia, President; Ronald Anderson, Vice-President; Robert Potter, Secretary;
Annette Johnson, Member; Owen McCulloch, Member
James Gallegos, Superintendent
Name and grade level(s) of child/children_______________________________
Name(s) of parent/guardian(s)________________________________________
Date:_________________
School:__________________________________
Our bilingual program requires that we do a survey of languages spoken within our school district. To
better serve the needs of our students, we need your cooperation by answering the following questions.
Thank you for your time and assistance.
1. What language or languages are spoken at home?
Spanish_____
English_____
Both_____
Other_____
2. What language or languages are spoken in a family or close friend’s home
where your child spends significant time?
Spanish_____
English_____
Both_____
Other_____
3. What was the first language spoken by you, the parents, caretaker or
guardians, when you were children?
Spanish_____
English_____
Both_____
Other_____
4. What language or languages does your child understand?
Spanish_____
English_____
Both_____
Other_____
5. What language or languages does your child speak at home?
Spanish_____
English_____
Both_____
Other_____
6. What language or languages does your child read at home?
Spanish_____
English_____
Both_____
Other_____
7. What languages does your child write at home?
Spanish_____
English_____
Both_____
Other_____