Fillable English Language Requirement Form (Durham Technical Community College)

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English Language Requirement Form (Durham Technical Community College)

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Country of origin: US
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English Language Requirement Form
All health care workers (native and non-native US English speakers alike) are expected to use
clear communication skills in the workplace. Students whose native language is not U.S. English
are expected to demonstrate "near native" US English language abilities. To confirm this ability, all
students entering a Health and Wellness program are required to meet the English language
requirement.
All students should submit this form to the Admissions, Registration, and Records office to verify
how they meet the English language requirement.
Students meeting the following criteria must comply with this revised requirement:
1. Students who applied to a Health and Wellness program on or after January 1, 2016, OR
2. Students who applied to a Health and Wellness program before January 1, 2016, but have
not yet met the previous English language requirement.
Please check the ONE that applies:
1. ☐ I have only attended a US high school, and my first language is U.S. English.
2. ☐ I have attended school outside the United States.
3. ☐ My first language is not U.S. English.
If
you checked number 1, please sign here. There is nothing further that you need to do.
I understand that this is an official Durham Technical Community College document and that any
falsification on this document may result in disciplinary action according to the Student Code of
Conduct.
My signature below indicates that I am responding truthfully.
Student Name (Print): ________________________ Student ID: __________________
Student Signature: ___________________________ Date: ______________________
If you checked number 2 or number 3, you must meet the English Language Requirement by
successfully completing one
of the following options:
• Option 1: Take the Duolingo English Test and score 100 points or higher.
• Option
2: Take the Test of English as a Foreign Language (TOEFL), iBT version (obtain a
score of 22 in listening and above 26 in speaking.
• Option 3: Complete EFL 055 and/or EFL 064 and other EFL courses as recommended or
required by placement testing (obtain a score of 80 percent or above).
*No
te: Scores for the above tests and classes are valid for up to 5 years.
July 1, 2020 1
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I understand that this is an official Durham Technical Community College document and that any
f
alsification on this document may result in disciplinary action according to the Student Code of
Conduct.
I answered “no” to questions number 2 and/or number 3; however, I have met the English
Language Proficiency Requirement as follows:
1. ☐ I have taken the Duolingo English Test and scored 100 points or higher.
2. ☐ I took the Test of English as a Foreign Language (TOEFL), iBT version and scored above
22 in listening and above 26
in speaking.
3. ☐ I have completed one or more EFL curriculum courses in the areas listening/speaking
and have scored an 80 percent or higher.
My signature below indicates that I am responding truthfully.
Student Name (Print): ________________________ Student ID: __________________
Student Signature: ___________________________ Date: ______________________
EFL Director (Print): _____________________________________________________
EFL Director Signature: ________________________ Date: _____________________
This form must be submitted to your admissions counselor with other required
documentation. Refer to the Health and Wellness program admissions
checklist to determine
additional requirements.
July 1, 2020
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English Language Requirement Form (Durham Technical Community College)

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Completed 26 July 2020

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