Questionnaire Text

Questionnaire form view entire document: text image

14.

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

[] Yes
[] No - skip to question 15a

b. What is this language?

______

For example: Korean, Italian, Spanish, Vietnamese

c. How well does this person speak English?

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

Questionnaire instructions view entire document: text image

Answer person questions 7 through 17 for all persons on pages 2, 3, and 4.

Questions 7-48 are a continuation of the questions for each person. Questions 7-48 are a continuation of the questions for each person. (Questions 1-6 appear on pages 2, 3, and 4 of the questionnaire.)

14b. 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.