Questionnaire Text

Questionnaire form view entire document: text image

13a. Does this person speak a language other than English at home?

[] Yes
[] No -- Skip to question 14

[13b. and 13c are asked if the person can speak a language other than English at home.]
13b. What is this language? ____

For example: Korean, Italian, Spanish, Vietnamese

13c. How well does this person speak English?

[] Very well
[] Well
[] Not well
[] Not at all

Questionnaire instructions view entire document: text image

[Answer Housing Question 7-14 for all residents]

13.
13a. Mark the "Yes" box if the person sometimes or always speaks a language other than English at home. Mark the "No" box if the person speaks only English, or if a non-English language is spoken only at school or is limited to a few expressions or slang.
13b. Print the name of the language spoken at home. If this person speaks more than one non-English language and cannot determine which is spoken more often, report the one the person first learned to speak.