Bilingual/ESL Enrollment Summary
Student Name / DateSSN/ID# / Home Language
☐ 01 Spanish ☐ 98 English ☐Other (Please Write In)
Code LEP Status Date
Please select a LEP indicator code and an effective date. If LEP is 1 a Parent Permission Code must be provided. / ☐0 / Not Identified as LEP
☐1 / Identified as Limited English Proficient LEP
☐F / Student Exited from LEP Status –Monitored 1 (M1) Not Eligible for funding
☐S / Student Exited from LEP Status –Monitored 2 (M2) Not Eligible for funding
Non- Funded
Parent Permission Codes
Students with these codes will not generate funds from the Bilingual or ESL Program. / ☐3 / Parent or Guardian requested Placement of Non-LEP Student in Bilingual Program
☐7 / Parent or Guardian did not respond
☐8 / Parent or Guardian was not contacted
☐C / Parent or Guardian has denied placement of a LEP Student in Any Special Language Program
☐G / Parent or Guardian has approved placement of a recently exited Non-LEP in a Bilingual or ESL Program
☐H / Parent or Guardian has requested placement of a Non-LEP Student in the ESL Program
FUNDED
Parent Permission Codes / ☐A / Parent or Guardian has denied placement of a LEP Student in the Bilingual Program BUT has approved placement of LEP student in ESL Program
☐B / Parent or Guardian has approved placement of Grade PK-8 Student in the ESL Program
☐D / Parent or Guardian has approved placement of LEP Student in Bilingual Program
☐E / Parent or Guardian has approved placement of LEP Student in
☐F / Parent or Guardian of a Grade 9-12 LEP student has approved services in accordance with the LPAC Plan
☐J / Parent or Guardian has approved the placement of a LEP student in the ESL Program BUT the program is an alternative language program approved by TEA
ESL Enrollment Program Type Date
☐0 / Student Does Not Participate
☐2 / ESL Content Based
☐3 / ESL Pull Out
Bilingual EnrollmentProgram Type Date
☐0 / Student Does Not Participate
☐2 / Transitional bilingual/early exit
☐3 / Transitional bilingual/late exit
☐4 / Dual language immersion/ two way
☐5 / Dual language immersion/ one way
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Signature of ESL Representative Date
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Reviewed By Date