STATE OF DELAWARE
PARENT INFORMATION FORM
FOR ENGLISH LANGUAGE LEARNERS (ELLs)
Date: ______________________
Student’s Name:____________________________________________ Grade: ________
Birthdate: ____________________
State I.D.: ___________________________
School: _______________________________ District: __________________________
Through an English language proficiency assessment, ACCESS (Assessing Comprehension and
Communication in English State to State), your child has been identified as an English language
learner (ELL) with a proficiency level of:
Check which one applies:
Annual ACCESS test ___
Composite Proficiency Level:
1 ___
2 ___
3 ___
4 ___
5 ___
6 ___
ACCESS Placement test (W-APT) ____
KN Placement test MODEL ____
Composite Proficiency level:
1 ___
2 ___
3 ___
4 ___
5 ___
6 ___
1-Entering; 2-Beginning; 3-Developing; 4-Expanding; 5-Bridging; 6- Reaching
Your child will receive specialized instruction in order to increase her/his English proficiency in
speaking, listening, reading, and writing skills.
Type of Program/Instruction (See last page for definitions):
 Developmental/Maintenance Bilingual
___
 Transitional Bilingual
___
 Two-Way Bilingual/Dual Language
___
 ESL (push-in)
___
 ESL (pullout)
___
 Regular Classroom Instruction
___
 Sheltered/Structured English
___
 Other(Describe): _____________________________________________________
Page 2
Exit criteria: Please check:




Grades 1-12: Tier C with a proficiency level of 5 or above on ACCESS
KN: Accountability proficiency level of 5.8-6.0
DCAS scores
Grades

Other Describe) ____________________________________________________
___
___
___
___
________________________________________________________________________
________________________________________________________________________
For a Special Ed/ELL student: The IEP meets the following objective(s):
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
You have the right to refuse enrollment in the above program, or to remove your
child from an existing program through a written request signed and dated to be
kept in your child’s school file.
We encourage you to be active participants in your child’s education to assist them in
attaining English proficiency and in meeting the State’s challenging academic
achievement and content standards. To learn more about how to be involved in the
education of your child, please plan to attend the following parent meeting(s):
_______________________________________________________________________.
You also have the right to request regular meetings to discuss your child’s achievement
and any other recommendations you have for improving our programs and services.
Finally, we would also like you to know about the following resources that are available
to you to assist your child in improving their English proficiency and academic
achievement:
_______________________________________________________________________.
Program Definitions:
Developmental/Maintenance: Provides mostly native language instruction to ELLs at
first, and then instruction in English increases as proficiency increases.
Transitional: Provides structured English instruction and native language support when
needed to ELLs.
Two-Way Bilingual/Dual Language: Provides English and native language instruction
to both language majority and ELLs.
ESL Pull-Out: ESL teacher pulls ELLs out of regular classroom to provide structured
English and content-based instruction for short periods of time.
ESL Push-In: ESL teacher provides structured English and/or native language support in
the regular classroom setting.
Sheltered/Structured English/Content-Based Immersion: Provides ESL and content
area instruction to ELLs in a classroom setting, or for certain subjects or periods of a day.