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ENG 6500Dr. Bonnie ParsonsPreparation #2Presented by Ana T. Solano-Campos.
Create a student and family intake questionnaire that asks, in a non-threateningmatter, key questions about the sociocultural backgrounds of CLD students.
This questionnaire is based on a section of Ovando, Combs, & Collier’s,
 Bilingual & ESL Classrooms
(2006, p.32). Ideally, conducting a meeting with the parentsand a translator in order to get this information would be the best option. However, providing translations for the questions, in the parents’ native language, would be a goodidea in case that meeting or making an appointment with a translator is not possible.A very special feature of this questionnaire is layout. Most questionnaires I haveseen are not “friendly”. They have few pictures and are really wordy. Shorter sentencesand more visuals are intended to make parents feel more enthusiastic about filling in thequestionnaire. This questionnaire is made up of thirty questions: ten about the parent, tenabout the student, and ten about academics. The three parts can be sent home as one, or the can be sent one at a time. In the event that a parent has several children attending thesame school, he or she can fill in the information for all the children on the same form or fill in a different form for every child.
 
WELCOME!
WE ARE HAPPY YOU AND YOUR CHILD ARE NOW PART OF OUR SCHOOL FAMILY.PLEASE TELL US MORE ABOUT YOURSELF AND YOUR CHILD.This information will be kept
confidential
.
ABOUT THE PARENTS
What is your name?Where were you born?What is your occupation?What languages do you speak?In what languages do you speak with your children?When did you move to the United States? Why?Where did you live before moving to the United States?Where do you live now? Do you like it there?How many people live with you and your child?Do you still have relatives in your home country or another country?
Thanks for your time!
 
WELCOME!
WE ARE HAPPY YOU AND YOUR CHILD ARE NOW PART OF OUR SCHOOL FAMILY.PLEASE TELL US MORE ABOUT YOURSELF AND YOUR CHILD.This information will be kept
confidential
.
ABOUT SCHOOL WORK
Does anyone at home help your child with homework?What kinds of reading materials do you have at home?Do you or your child have a library card?How often do you go to the public library?How much time does your child spend doing school work?How much time does your child spend reading?How much time does your child spend doing homework?How much time does your child spend watching TV?Do you read to your child in your native language?What activities does your family enjoy doing together? 
Thanks for your time!
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