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Community

English Program: Fall 2014

My Name:

Instructor: Emily Jones

Getting To Know You


Advanced
Teachers College Columbia University



When I came to the U.S.:

My native language is:

Other languages I know:

What is your background in learning and speaking English?


improve my speaking

My goals are to (check all that apply):


get a job

get a better job

improve my writing

improve conversation skills

for testing purposes in U.S.

improve my reading

improve my grammar

learn about American culture

other: __________________


Self-Assessment of English Skills
For each area listed below, place a check mark in the column that best matches your skill level

1 = Very Weak
2 = Weak
3 = Average
4 = Strong
5 = Very Strong


1
2
3
4
5
Reading

Writing

Listening

Speaking

Grammar

Vocabulary



What topics interest you? (check all that apply)
American culture

Global issues

Business

Sports

Travel

Cooking/Food

Other: ______________________

Technology
Fashion

Community English Program: Fall 2014

Instructor: Emily Jones

Which activities are most helpful to your English learning? (check all that apply)
watching TV

listening to audio files

listening to songs

field trips

pair/group work

writing

games

pronunciation drills

grammar practice

reading

conversation

other: _____________________


Genre Preferences
This section will tell me what types of texts are familiar to you. Please place a check mark () in the column that
best describes your experiences.

O = I read this kind of text S = I sometimes read this
N = I never read this kind
DK = I dont know about
often
kind of text
of text, but I know what it this kind of text
is

How often do you read the following kinds of texts (genres) in English?

DK

Fiction (e.g., novels, short stories)

Non-fiction (e.g., biographies, history, travel, popular science)

Poetry

Newspapers and newsmagazines

Technical and practical texts (e.g., cookbooks, manuals)

Comic books

Websites

Blogs

Other (please specify):




What devices do you own or have access to? (check all that apply)
computer
laptop

smartphone


Why did you enroll in this class?

tablet

internet

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