ESOL Permission / Waiver
    New Enrollment
    Student Name _________________________
    ID _________________________
    School / Grade _______________________
    Dear Parent / Guardian:
    Your student’s enrollment
    form indicated that another language is spoken in your home. For this reason
    your student was tested to determine their proficiency in English. Upon completing the
    Idea English
    Proficiency Test (IPT)
    for Early Childhood students or the
    Kansas English Language Proficiency
    Assessment/Placement (KELPA/P)
    for K-5
    grade students, it was determined that your student is not
    proficient in either oral and/or written English and qualifies for ESOL (English Speakers of Other
    Languages) services in USD 261.
    The ESOL program is designed to help your student become proficient in English throughout their school
    subjects. A learning plan will
    be written to accommodate your student’s needs, and services
    available in one or more of the following ways:
    _____ * ESOL Newcomer Class: providing English/Language assistance for non-English speakers
    _____ * ESOL Pull-Out: providing small group English/Language assistance away from the classroom
    _____ * ESOL Inclusion: providing ESOL personnel in the classroom for English/Language assistance
    _____ * ESOL Computer Assistance: providing technology to increase English/Language proficiency
    _____ * ESOL Modified Instruction: providing ESOL endorsed teachers making content understandable
    When your student becomes proficient in English, as determined by their annual Kansas English
    Language Proficiency Assessment, they will be exited from the ESOL program. Following their exit from
    the program, a two year period of monitoring will occur in order to check their maintained proficiency.
    It is your right as a parent/guardian to
    or to
    ESOL services for your student.
    I have been informed of the procedures used to identify my child for ESOL services.
    I understand that my child qualifies to receive ESOL services.
    I understand that my child’s
    English proficiency will be tested annually as federal law requires.
    With this understanding:
    I give permission
    for my child to receive ESOL services.
    I waive ESOL services
    for my child, understanding that
    the annual KELPA will be administered
    ESOL Teacher
    Building Principal

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