Needs Analysis
Name:
Email Address:
Phone Number:
1. Where are you from? What is your first language?
2. Do you speak any other languages besides English?
3. What is your professional background (e.g., your job and/or school major)?
4. How long have you been living in the U.S.? How long do you plan to stay?
5. How many years have you studied English (formally/informally)? Where have you studied?
6. Which language skills do you feel most comfortable with? (Check all that apply)
☐Reading ☐Writing ☐Speaking ☐Listening
7. Which skills would you like to improve? (Check all that apply)
☐Reading ☐Writing ☐Speaking ☐Listening ☐Grammar ☐Pronunciation
8. (What) do you usually read in English (newspaper, Internet, book, etc.)? How often?
9. Outside of class, where do you write and speak English?
10. Are you a user of these websites? (Check all that apply)
Google ☐YouTube ☐Facebook ☐Twitter ☐Instagram ☐Other:__________
11. Why are you studying English? What are your goals?
12. Tell us more about yourself (on back).