Parent Language Survey

Number of Children at BJCCS REQUIRED Please fill out this field.
Child 1
- First Name REQUIRED Please fill out this field. Please enter valid data.
- Middle Name Please enter valid data.
- Last Name REQUIRED Please fill out this field. Please enter valid data.
- Sex REQUIRED Please fill out this field.
- Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
- School Please enter valid data.
- Race (check all that apply) REQUIRED African American/Black American Indian/Native Alaskan Asian Hawaiian/Pacific Islander White Two or more races Please fill out this field.
- Ethnicity: Is the student Hispanic or Latino? REQUIRED Yes No Please fill out this field.
Child 2
- First Name REQUIRED Please fill out this field. Please enter valid data.
- Middle Name Please enter valid data.
- Last Name REQUIRED Please fill out this field. Please enter valid data.
- Sex REQUIRED Please fill out this field.
- Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
- School Please enter valid data.
- Race (check all that apply) REQUIRED African American/Black American Indian/Native Alaskan Asian Hawaiian/Pacific Islander White Two or more races Please fill out this field.
- Ethnicity: Is the student Hispanic or Latino? REQUIRED Yes No Please fill out this field.
Child 3
- First Name REQUIRED Please fill out this field. Please enter valid data.
- Middle Name Please enter valid data.
- Last Name REQUIRED Please fill out this field. Please enter valid data.
- Sex REQUIRED Please fill out this field.
- Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
- School Please enter valid data.
- Race (check all that apply) REQUIRED African American/Black American Indian/Native Alaskan Asian Hawaiian/Pacific Islander White Two or more races Please fill out this field.
- Ethnicity: Is the student Hispanic or Latino? REQUIRED Yes No Please fill out this field.
Child 4
- First Name REQUIRED Please fill out this field. Please enter valid data.
- Middle Name Please enter valid data.
- Last Name REQUIRED Please fill out this field. Please enter valid data.
- Sex REQUIRED Please fill out this field.
- Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
- School Please enter valid data.
- Race (check all that apply) REQUIRED African American/Black American Indian/Native Alaskan Asian Hawaiian/Pacific Islander White Two or more races Please fill out this field.
- Ethnicity: Is the student Hispanic or Latino? REQUIRED Yes No Please fill out this field.

What is the primary language used in the home, regardless of the language spoken by the student? REQUIRED Please fill out this field. Please enter valid data.

What is the language most often spoken by the student? REQUIRED Please fill out this field. Please enter valid data.

What language did the student learn first? REQUIRED Please fill out this field. Please enter valid data.

Does the parent/guardian need interpretation services? REQUIRED Yes No Please fill out this field.

Does the parent/guardian need translated materials? REQUIRED Yes No Please fill out this field.

Parent/Guardian e-signature REQUIRED Please fill out this field. Please enter valid data.

Date REQUIRED Please fill out this field. Please enter a date.

Email REQUIRED Please fill out this field. Please enter an email address.

Bishop John Carroll Cathedral School

1100 NW 32nd St, Oklahoma City, OK 73118
(405) 525-0956

Parent Language Survey