Community English Program (CEP)

Teachers College, Columbia University

Level: Intermediate 2 (I2)
Instructor: Jasmine Kim
Fall 2015

Needs Analysis
This is a survey to help me get to know you and your needs better so we can learn the most in our future classes.
This is NOT a test. Please answer honestly and thoughtfully.
General Information:
Name: ____________________________
Nickname/Preferred Name: ____________________________
Age (Optional): ____________________________
Nationality: ____________________________
Email: ____________________________
Phone: ____________________________
Your Language Background:
1. When did you come to the U.S.?
_______________________________________________________________________________________
_______________________________________________________________________________________
2. What is your native (first) language?
_______________________________________________________________________________________
_______________________________________________________________________________________
3. Do you know any other languages? If yes, what are they?
_______________________________________________________________________________________
_______________________________________________________________________________________
4. Have you learned English before? If yes, where and for how long?
_______________________________________________________________________________________
_______________________________________________________________________________________
5. Did you work in your home country? If yes, what was your job?

_______________________________________________________________________________________
_______________________________________________________________________________________
6. Are you currently employed? If yes, what is your job and where do you work?
_______________________________________________________________________________________
_______________________________________________________________________________________
7. Your goals are to (Check all that apply):
get a job

get a better job

improve your speaking

improve your reading

improve your listening

improve your writing

improve your pronunciation

improve your grammar

get more education

learn about American culture

other: ______________

8. What do you think you are good at in English?

Reading

Speaking

listening

writing

grammar

other: ______________

9. Please rate your current strengths for the following:

5 Very strong

4 Strong

3 Average

2 Weak

1 Very weak

Listening
Speaking
Reading
Writing

Your Learning Style:

10. What ways help you learn English? Check all that apply.
Watching TV/Movies

Watching news

Listening to music

Reading (books/newspapers)

Writing (essays/journals) Grammar drills

Speaking with others

Pair/Group work

Other: ____________

11. What are you interests? Check all that apply.

Sports

Science

Technology Fashion

Politics

News

Travel

Global issues

Language and Culture

Other: _____________________________

Music
Business

Food
Movies

12. Do you like working alone or in groups?

Yes -- No

13. Do you have access to a computer or laptop?

Yes -- No

14. How often do you use a computer or laptop? Check one.

Very Often
Often
Sometimes
Seldom
15. Do you own a smartphone or tablet?

Very Seldom

Yes No

16. How do you primarily use technology?

Social Networking

Doing Homework

Entertainment

For Work

Other: ______________
17. Where do you want to speak better English?
at work

on the bus/train

with friends

with neighbors

in stores

on the telephone

other:_____________

18. Do you want to read/write better English for?

checks/bills

forms

job applications

at work

maps/directions

ads in newspapers

catalogs

work notices

your childrens report cards/school notes

other:________________

19. Is there anything else you would like me to know?

__________________________________________________________________________________________
__________________________________________________________________________________________
Thank you for completing this survey! Your answers will help me design the best course for your needs.