Northwest ISD Pre-Kindergarten
LPAC Initial Review
To be completed prior to placement in Pre-Kindergarten
Grade: / LPAC Date:
Academic Year: / Home Language HLS Date:
Identification
Oral Language Proficiency Test: English score: Primary language score:
LPAC NOTES / LPAC Recommendations
Level of English Language Proficiency Based on Test(s) Administered:
Non-English Speaking (PK Eligible based on ELL/LEPlanguage testing and identification)
Limited English Speaking (PK Eligible based on ELL/LEP language testing and identification)
Fluent English Speaking (NOT PK Eligible based on ELL/LEP language testing)
LPAC Recommendations:
English Language Learner (ELL / LEP Indicator Code 1)
Parent Permission Code (PPC):
Parent permission date:
A - Parent or guardian has denied placement of LEP student in the required bilingual program, but has approved placement of LEP student in the ESL program (i.e., Parent has not chosen the District Spanish Bilingual Program but has accepted the ESL program within the campus/district)
B - Parent or guardian has approved placement of LEP student in the required ESL program, but has not denied placement in the bilingual program, if applicable (i.e., any PK Non-Spanish speaking students who would not benefit from the District Spanish Bilingual program due to other languages)
D - Parent or guardian has approved placement of LEP student in the bilingual program (Transitional Bilingual Program - Roanoke)
Parent Denial (if applies):
Parent denial date:
C- Parent or guardian has denied placement of LEP student in any special language program)
Non-LEP and Regular English Program (Student does not qualify for ESL Services and is NOT PK Eligible based on Language)
Language Program Placement if ELL/LEP:
Enter ESL program
2 – ESL / Content-Based (All areas ESL serviced)
3 – ESL / Pull-Out (Only LA instruction ESL serviced)
Enter Bilingual program
5 - Dual Language / Immersion - One-Way
LPAC Signatures(*Required Members)
ESL Educator*:
______
Bilingual Educator* (if Transitional Bilingual): ______
Campus Administrator*:
______
Parent* or Parent Representative*: ______
ARD Committee Representative (if needed)*:
______
Northwest ISD Parent Notification/Approval
of Entry into Bilingual/ESL Program
Student name: / Enrollment date:Grade: / LPAC date:
Academic year: / Home Language Survey date:
Northwest Independent School District is committed to provide instructional and enrichment programs that will meet the needs of the pupils in our school. We provide our Special Program so that your child will develop the English language skills necessary to be successful in the total school program. Our Special Language Program is structured language instruction designed to teach English to students whose English language skills are limited.
It is a pleasure to inform you that your child has qualified for the English as a Second Language Program and will be placed in the program with your permission. Please sign and return to me as soon as possible.
If you have any questions, I will be happy to meet with you.
Please check one.
______I wish for my child to be enrolled in the Special Language Program (Specified in LPAC).
Parent’s Signature ______Date ______
______I do not wish for my child to be enrolled in the Special Language Program (Specified in LPAC).
Parent’s Signature ______Date ______
Este distrito escolar se ha comprometido a proveer instrucción y programas de enriquecimiento que reunirán las necesidades de los estudiantes en nuestras escuelas.
Proveemos el programa especial idioma para que su hijo/hija desarrolle las destrezas necesarias del idioma ingles para tener éxito en el programa total de la escuela. Nuestro programa es instrucción de la formación del lenguaje designado para ensenar el idioma ingles a los estudiantes lo cuales tienen problemas con el idioma.
Es un placer informale que su hijo/hija ha calificado para asistir a las clases de el programa especial idioma y estara en este programa con su autorización. Favor de firmar la forma de abajo y regresarla lo mas pronto posible.
Si usted tiene alguna pregunta, sera un placer reunirme con usted.
______Estoy de acuerdo para que mi hijo/hija asista a las clases del programa especial de idioma.
Firma del padre ______Fecha ______
______NO estoy de acuerdo para que mi hijo/hija asista a las clases del programa especial de idioma.
Firma del padre ______Fecha ______