Community Language Program

Level: Advanced 4 (A4)

Instructors: Kaitlin Griswold and Mallory Massie

Term: Fall 2014
Getting to Know You
Welcome to A4 at the CEP! We are very excited for the semester, and we believe we are going to discuss
some really important topics. However, we want to teach you things that you want to learn, and we want to be
able to do that in the best way possible. Please complete the following survey so that we have a better
understanding of how to best further your English language learning.
Dont worry this is not a test!

1. Name/Nickname: ____________________________________________________________________
2. Email: _____________________________________ Phone: _________________________________
3. What is your nationality? ______________________________________________________________
4. How long have you studied English? _____________________________________________________
Where did you study? _______________________________________________________________
5. What language(s) do you speak at home? ___________________ At work? ______________________

This particular class may integrate technology into our language learning experience. Please make a
checkmark indicating that you have access to the following (check all that apply):
_____ Computer

_____ Laptop

_____ Tablet

_____ Smartphone

_____ Internet

What topics interest you? (Check all that apply)

American culture Social networking (i.e. Facebook) Global issues Business
Technology Travel Cooking/food Fashion Sports Movies
Other:__________________________

What kinds of things do you want to be able to do in English? (Check all that apply)
watch movies / TV

Read newspapers / magazines

Speak with people in stores / shops

Read books / novels

Use English at work Use English with family Listen to the radio

Write papers for school / academic purposes Other: ______________________________________________

Community Language Program

Level: Advanced 4 (A4)

What English skills are most important to you?

Please circle the words that best describe your feelings about each skill:
SPEAKING is

most important

very important

important

less important

not important

PRONUNCIATION is most important

very important

important

less important

not important

LISTENING is

most important

very important

important

less important

not important

READING is

most important

very important

important

less important

not important

WRITING is

most important

very important

important

less important

not important

Self-Assessment
For each category below, place a check mark in the column that best describes your skill level.
1 = Very Weak

2 = Weak
1

3 = Average
2

4 = Strong
3

Reading
Writing
Listening
Speaking
Grammar
Vocabulary
Pronunciation

What skills do you want to focus on? Please explain (from the table above).

What skills do you need to review? Please be specific.

5 = Very Strong
4

Community Language Program

Level: Advanced 4 (A4)

Reading Experience
Please indicate your experience level with each of these types of texts as O (I read this text often), S (I sometimes
read this text), N (I never read this text, but I know what it is) or DK (I dont know what this kind of text is)1:
______ College textbooks
______ Academic Articles
______ Fiction
______ Non-Fiction
______ Poetry
______ Newspapers and Newsmagazines
______ Magazines
______ Technical Texts (for example, cookbooks, manuals)
______ Comic Books
______ Webpages
______ Blogs
______ Other (please specify) ________________________

Short Answer
What brings you to New York City?

Please describe the best experience you have had (so far) in New York City.

Do you have any questions for us?

Is there anything else you want us to know about you?

Adapted from Hedgecock and Ferris, Teaching Readers of English, 2009.