Needs Assessment

Name:
Email Address:

Personal Information
1. What is your first (native) language?

2. Do you speak any other languages besides English?

3. How long have you been living in the U.S? How long do you plan to stay?

Background Information
1. How many years have you studied English (formally/informally)? Where have you
studied?

2. Which language skills do you feel most comfortable with (listening, reading, writing,
speaking)?

3. Which skills would you like to improve?

4. (What) do you usually read in English (newspaper, internet, book, etc.)? How often?

5. Outside of class, where do you write and speak English?

6. Why are you studying English? What are your goals?

7. Tell me about yourself (on back).