Community English Program (CEP)

Teachers College, Columbia University

Level: Advanced 3
Instructor: Aaron Braten and Jasmine Kim
Spring 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: ____________________________
Nationality: ____________________________
First Language: ____________________________
Email: ____________________________
Phone: ____________________________
Your Language Background:
1. How many years have you studied English?
2. Where have you studied English?
3. What other languages do you know? How fluently (beginner/intermediate/advanced)?
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4. What is your goal for learning English? Check all that apply.
Academic needs

Job requirement

Learn about America

Daily communication

Language exam (e.g. TOFEL, IELTS)

 Other: ____________________________
5. Please rate your current strengths for the following:
5 Very strong

4 Strong

3 Average

2 Weak

Listening
Speaking
Reading
Writing

Your Learning Style:

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

Watching news

Listening to music

Reading (books/magazines/newspapers) Writing(essays/journals)

Grammar drills

Speaking with others

Other: ____________________________
7. What are you interests? Check all that apply.
Sports

Science

Technology Fashion

Politics

News

Travel

Global issues

Food

Music

Language and Culture

Movies
Business

Other: _____________________________
8. Do you have access to a computer or laptop?

Yes -- No

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

Very Often Often Sometimes Seldom Very Seldom
10. Do you own a smartphone or tablet?
11. How do you primarily use technology?

Yes -- No

Social Networking

Doing Homework

For Work

Other ______________

Entertainment

1 Very weak

12. Briefly comment on what you like or dislike about technology.

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13. Is there anything else you would like me to know?
_______________________________________________________________________________
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Thank you for completing this survey! Your answers will help me design the best course for your
needs.