Community Language Program Student Name: ______________________________

Spring 2023

Needs Assessment
I. Tell me about yourself:

1. Where are you from (city/country)? ______________________________________________

2. What is your native language? __________________________________________________

3. What other languages do you speak? _____________________________________________

4. How long have you lived in the U.S.? ____________________________________________

5. How long have you been studying English? Where?

____________________________________________________________________________

____________________________________________________________________________

II. Tell me about your English use:

1. Where did you speak English this week and to whom? (E.g., at work with my co-worker)

2. What did you write in English this week? (E.g., a text message, an email, an essay, etc.)

3. What did you read in English this week? (E.g., a novel, a newspaper online)

4. Typically, how long do you use English every day (hours)?

5. How many hours per week can you study English outside school?
Community Language Program Student Name: ______________________________
Spring 2023

III. Why are you studying English?

First, circle your reason/s for studying English. You can circle more than one. Then, circle one
number from 1 to 5 to show how important the chosen reason is for you.

1= Not important 5=Very important

Pass TOEFL exam 1 2 3 4 5

Attend school/university in English 1 2 3 4 5

Participate in meetings/discussions 1 2 3 4 5

Give presentations 1 2 3 4 5

Communicate in every day life 1 2 3 4 5

Improve my professional qualifications 1 2 3 4 5

Get a higher salary 1 2 3 4 5

Other ________________________________________________________________________

IV. Tell me something more about yourself (your culture, your hobbies, your life, etc.)

Let’s have a great semester!