Needs Analysis

Part A

Name: __________________________
Age: 18-21 22-25 26-29 30 and over

o ESL Summer / Winter study abroad program

o International student - undergraduate /graduate

What is your current
Student Status? o University student

o Non-university student

Which of the following describes your living situation? Circle one

university housing homestay off-campus country of origin (native country)

____________________________________________
Part B

How would you rate your ability to communicate in English? Check the one
which best matches your English conversation level.
□ Basic – Very limited vocabulary. Word order and grammar are consistent with native
language.
□ High-beginner – Limited working vocabulary. Word order (Subject / verb / modifiers /
object) is improving. Difficulty in using correct verb tense and use
□ Intermediate – Can express oneself using some descriptive vocabulary. Able to link
thought and ideas. Fluency is improved, though sentences show grammar errors.
□ Upper intermediate – Can speak about a variety of topics comfortably. Only minor
errors with verb tense, word order, and article omission.
□ Proficient – Ability to structure long sentences with descriptive vocabulary. Can
incorporate language consistent with various contexts. Awareness of proper grammar
and word use and placement. Difficulty using idioms, jargon, and expressions.

On a scale of 1 – 4, how would you rate your writing proficiency in your

native language? Circle one
(1) Below average (2) Average (3) Above average (4) Exemplary
Which of the following best describes the type(s) of writing you most often do
in your native language? Check all that apply
□ Email □ Poetry
□ Business Memo □ Short stories
□ Business letter □ Daily plan / organizer
□ Diary or Journal □ Text messaging
□ Blog □ None
□ Facebook / SNS □ Other

Part C

Have you taken any English language courses in the past? Yes No
If yes, please explain here. ________________________________________________________
______________________________________________________________________________

What is your primary reason(s) for taking this course? Check all that apply
□ TOEFL test □ Course □ Occupational □ Personal
preparation prerequisite (Job)

In your experience writing in English, what gives you the most problems.
Please explain in 1 or 2 sentences. _________________________________________________
_____________________________________________________________________________

__________________________________________________________________

In this classes you will be working with your classmates? Which size of group
are most comfortable with? Circle one
Pairs (2 students) Small Groups (3-4 students) Large groups (5-6 students)

Do you have any physical or personal issues that may make it difficult to
complete the coursework? Please share with me before at the start of class.