English Learner FormsSamples of commonly used English Learner program document templates that may be used by a local educational agency.
Clearinghouse for Multilingual Documents
A repository of translated documents contributed by local educational agencies and those published by the California Department of Education.
Home Language Survey
California Education Code, Section 52164.1 (a) contains legal requirements which direct schools to determine the language(s) spoken in the home of each student. This sample form is designed to assist with the identification process.
- Home Language Survey form English (DOC; Revised Dec-2016)
- Available Translations of the Home Language Survey form (Revised Dec-2016)
Informal Primary Language Assessment
Tool that may be used, along with the results of the California English Language Development Test, to design appropriate instruction and support services for English learners.
- Informal Primary Language Assessment sample form English (DOC; Revised Dec-2010)
- Available Translations of the Informal Primary Language Assessment form
Parent Notification Letters
Sample templates a local educational agency may use to meet Tile III and State requirements for notifications to parents or guardians of English learners.
- Initial Notification of Federal Title III and State Requirements Status English (DOC)
- Annual Notification of Federal Title III and State Requirements Status English (DOC)
Semiannual Certification and Personnel Activity Report
The Office of Management and Budget (OMB), is a policy directive affecting which costs are allowable charges to federal programs, which costs are not allowable, and how costs must be documented. OMB Circular A-87 applies to all local educational agencies receiving federal funds, including certification of salaries and wages cost charged to federally funded programs. Sample certifications may be found on page 15 and 16 from the January 10-11, 2007, State Board of Education Agenda, Item 20, Attachment 15 (DOC).