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________
Questionnaire instructions view entire document:  text  image
14a. 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.

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.