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HALF HOLLOW HILLS CENTRAL SCHOOL DISTRICT Department of English as a Second Language

REQUEST FOR NYSESLAT/LAB-R SCORES Please complete this form if the student has been identified as an English Language Learner

1. Student’s Name:

4. If yes, please list previous school(s):

2. Language(s) spoken by the student:

5. Did the previous district provide LAB-R or NYSESLAT scores? Yes/No (circle one) 6. If Yes, please provide the information in the chart below.

3. Date of entry to US schools? Did the student enter your district as a LEP student? Yes/No (circle one)

Last year in attendance

Grade Level

NYSESLAT Score L&S

R&W

Years in Program

LAB-R Prof. Level

Score

Prof. Level

A-7 (Part 154 Extension of Services Filed?) Yes/No Year

Please attach whatever supporting documents are needed so that we can have a complete history on the student. Please submit to the building requesting the information. Should you have any questions you may contact me at: Mr. Francesco L. Fratto Director of World Languages & English as a Second Language ffratto@hhh.k12.ny.us Tel (631) 592-3189 Fax (631-592-3927


Form Request