Needs Analysis Sample Questionnaire

 Part I: Personal and Professional Information

Name Age English Learning Experience
How long? Where?

Workplace Job Title Professional Experience

How long? Where?

Job Function

 Part II

1. Write 5 tasks you would like to be able to do better in English (e.g. write a technical report)
a) _________________________________________________
b) _________________________________________________
c) _________________________________________________
d) _________________________________________________
e) _________________________________________________

2. Please tell us about your English language level. Use numbers 1 to 5 which correspond to:
1 = Poor. 2 = Fair. 3 = Good. 4 = Very Good. 5 = Excellent.
a) Reading comprehension. ______
b) Speaking fluency. ______
c) Speaking accuracy. ______
d) Understanding of other speakers. ______
e) Writing accuracy. ______
f) Range of vocabulary. ______
3. Please tell us how much you expect to use English in the following contexts where 1-4 correspond to:

1 = Never. 2 = Rarely 3 = Sometimes 4 = Frequently 5 = Always

-------------- e.g. once a year e.g. once a month. e.g. once a week e.g. once a day

a) Reading reports, correspondences, etc. ______

b) Reading instruction manuals, technical articles, etc. ______
c) Telephone calls. ______
d) Conversation and informal meetings in small groups. ______
e) Participating in formal meetings. _____
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 f) Addressing an audience, giving presentations. ______
g) Taking notes during meetings, conferences, etc. _____
h) Writing business letters, emails, etc. ______
i) Writing reports. ______
j) Working with English speakers. ______
k) Travelling (airports, hotels etc.). _______
l) Extended visits abroad including social contact. ______
m) Looking after English-speaking visitors. ______
n) Operating machines. ______

 Part III
 Circle one option (yes or no), you can choose more than one option.
1. You like learning
a) Individually. Yes No
b) In pairs. Yes No
c) In small groups. Yes No
d) In one large group. Yes No

2. Do you have time to do homework? Yes No

If yes, how much time do you have for out of class assignments? (Use numbers 1, 2, 3, etc.)
______ hour(s) a day OR ______ hour(s) a week

3. How would you like to spend this time?

a) Preparing for the next class? Yes No
b) Reviewing the day’s work? Yes No
c) Doing activities based on your personal experience, work experience or interests? Yes No

4. What do you usually do to practice your English?

a) Read magazines, newspapers, etc.
b) Listen to the news.
c) Watch movies, TV series, documentaries, etc.
d) Talk/write to native speakers (e.g. online chat groups, penfriends, etc.)
e) Discuss with my friends, colleagues, etc.
f) Do exercises in grammar books.
g) other _____________________________________

5. Topics of interest: Please tick the topics you like the most
a) Music
b) Food
c) Environment
d) Science and Technology
e) Other cultures
f) English Culture
g) Travel
h) Sports
i) Politics
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