Language Acquisition Program Request

Form to request a Language Acquisition Program

Dear Parent/Guardians:

To enroll your child in a language acquisition program submit this form. You may also make a verbal request that the be complete for you by school personnel at the front office where your child is currently enrolled.

Language Program RequestsrequiredPlease select up to 1 choice

I am requesting that my child be placed in the language acquisition (dualimmersion/bilingual) program currently offered at my child’s school ofenrollment.

I am requesting that my child be placed in a language acquisition (dualimmersion/bilingual) program at any district school currently offering theprogram.

I am requesting the establishment of a new language acquisition program at mychild’s site of enrollment

Please select up to 1 choice

Student Namerequired

First Name

Last Name

Student Graderequired

Dropdown Menurequired

Parent Namerequired

First Name

Last Name

Email Address

Telephone

Must contain only numbers

Parent Consentrequired

By clicking here, I am confirming that all of the above information is correct and agree to the language program request being made.

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Form to request a Language Acquisition Program