Communicative English

Academic English Needs Analysis

I. About You
1. Your name: ________________________________ Preferred Name: __________________________________
2. Your nationality: _____________________________ Native language: ________________________________
3. Number of years you have studied English: ___________ Number of years in U.S.: _______________________
4. Arrival Date to U.S.: _____________________________
5. Which university will you attend? ______________________________________________________________
a) Your status at this university is:

Full acceptance

Conditional acceptance

6. When do you plan to start your university studies? Month _____ Day _____ Year _____
7. What is your intended major? _________________________________________________________________
II. Previous Education
1. Select all that apply:

High school

University (undergraduate)

Major: ____________________________________________

University (graduate)

Major: ____________________________________________

Ph.D.

Discipline: ________________________________________
Dissertation: _______________________________________

Professional school (e.g. Law School, Medical School): _________________________________________

III. Previous Employment (select one)

1. Have you worked in your intended field before? ___ yes ___ no
a)

If yes, for how many years? __________

IV. Language Experience

1. Do you speak more than one language? ___ yes ___ no
a)

If yes, which languages do you speak? _______________________________________________________

2. Which skill do you find easiest in English? (writing, speaking, listening, reading) __________________________
3. Which skill do you find most difficult? ________________________________________________________________________________

Communicative English
4. When you study English, do you like to use the following? (select all that apply):

Text books
Newspapers
Magazines
Radio
Videos (TV, movies, news programs, documentaries, DVDs etc.);
Novels
Short stories
Websites
Games
Other _________________________________________

5. Is there anything you do not like to use? _______________________________________________________

6. When you study English, do you like to: (select all that apply):

Listen only to the teacher;

Speak freely with my classmates;
Discuss specific topics formally in small groups;
Present information I have researched to large/small groups;
Work on projects individually without help from classmates;
Attend formal academic lectures;
Participate in informal debates on controversial topics and issues;
Read articles and prepare written reports or opinion papers;
I enjoy getting feedback on written assignments from my classmates.
I only like to get feedback from my teacher.
Other _____________________________________________.

V. Do you own or have access to any of the following? (select all that apply)
Computer

Internet

Tablet (iPad)

Smartphone

VI. Self-Assessment of English Language Skills

1. For each area listed below, place a check mark in the box that best describes your skill level.

Skills
Reading
Writing
Listening
Speaking
Grammar
Vocabulary

Very weak

Weak

Average

Strong

Very Strong

Communicative English
VII. English Learning Goals
1. How important is it to you to focus on the following skills? Place a check mark in the appropriate box.

Skills
Reading
Writing
Listening
Speaking
Grammar
Vocabulary

Not
Important

A Little
Important

Neutral

Important

Very
Important

2. What are you hoping to achieve in this class?

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3. Content Preferences -- What aspects of your educational field or career really interest you? Choose three or more
specific subject areas within your major that you would like to explore. For example, if your major is economics,
you might find yourself interested in: economic history, international economics, finance, and banking.
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VIII. Tell me a little bit more about yourself (e.g. interests, hobbies, family, etc.)
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