×General Information

Name:

Class/year: Gender ⬜x Male ⬜ Female

How long have you learned English : ⬜ 1-2 year(s) ⬜ 3-4 years ⬜x 5 years or more

What is your English level? (Circle one): Poor Less than Average X Average Good

Imagine the following situations. Choose the answer that best describes you:

1. You have trouble understanding what your English instructor is saying in class. Why is this?

X⬜ He/She is speaking too quickly. ⬜ You are not concentrating enough

You have a choice of two English courses at university. Which do you takchal ⬜ An easier
course that you will most likely pass without much trouble.

⬜ A challenging course that you will have to study hard for but still might not pass.

2. I fail my English course, because

⬜ I am not good at English. X I do not put in enough effort.

3. Your classmate is very good at English. Why is this?

⬜X He/She was born with great language ability.

⬜ He/She studies English hard every day.

4. If you have to work hard during English class, it means:

⬜ I am not smart.

⬜ X The more difficult the English task, the more motivated I become to put in effort.

5. I am learning English, because:

⬜ it is required in the program. ⬜X it is important for my future.

6. Your instructor asks a difficult question in class. You are not confident, but think you might
know the answer. What do you do?

⬜ Wait for someone else to answer the question.

X⬜ Raise your hand and try to answer the question.

7. During the English class,

 X⬜ I feel embarrassed when I make mistakes.
⬜ I don’t mind making mistakes because I can learn and improve.

8. General viewpoint of your own ability:

X⬜ Whenever I encounter problems in life, I always think: “I can’t do it”
⬜ ‘I can do it” is my motto

9. When other students do better than me in English class,

X⬜ it makes me feel inferior ⬜ I feel inspired

10. X⬜ While learning English, I avoid challenging assignments

⬜ Feeling challenged in learning English makes me want to try harder

11. How much do you agree with the following statements? (1= Completely Disagree,
2=.Disagree; 3=. Agree 4= Completely Agree)

Statement How much do you

agree
I believe some people are naturally more talented than others when it 2
comes to learning languages
I hate being corrected when I’m speaking in another language. 2
I avoid trying very difficult things in another language, especially in 1
front of others. They may find out I’m not very good.
I get frustrated easily when something is difficult and I want to be told 1
the answer.

12. What is your goal for this course?

I want to improve my English in the future.

13. What do you do to achieve your goal?

Spend a lot of time studying at home.

14. What are difficulties that you face when learning English?

I think it is communication skills.

What are your coping strategies?

Start leaening vocabulary.