Centre for Co-Curricular Studies

Imperial Horizons Programme 2014-15

MANDARIN QUESTIONNAIRE
Surname:

_____________________ First name: ______________________________

CID Number:

_____________

Language Course applied for: _______________

Please tick the boxes and answer the questions below as far as they correspond to your background
and present knowledge of Chinese. Read each statement carefully and do not miss out any relevant
part or parts.
I am a home student

My family is of Chinese extraction

My native tongue is: ___________________

There are Mandarin speakers in my family

I am an overseas student from

There are speakers of Chinese dialects other

(Please specify) ______________________

than Mandarin in my family

Part A Chinese script

1. I have no knowledge of Chinese script whatsoever.
2. I am familiar with Chinese script because I know or have studied
Mandarin Cantonese Japanese Other (Please specify)
3. I am familiar with Chinese script because I have:
attended a Chinese-medium school
a GCSE or similar formal qualification
attended Chinese school in addition to
in Cantonese
mainstream education
an A Level, or similar formal
had private tuition in Chinese script
qualification in Cantonese
from native speakers of Chinese
a GCSE, or similar formal qualification
learned some script from family
in Mandarin
members who are of Chinese
an A Level, or similar formal
extraction
qualification in Mandarin
studied Chinese script on my own

4. My present level of character knowledge is*:

< 100 100-300 300-700 700-1000 >1000 Native/near-native level

*N.B. Students registering for ML72 (Mandarin for Cantonese Speakers) should tick Native/near-native level

5. The following statement or statements best describe(s) my knowledge of script::

I am equally able to read and write the language
I know full-form (traditional) characters but not simplified
I know simplified characters but not full-form (traditional)
I can read a newspaper but I cannot write many characters
I have studied the basic strokes and stroke order but I cannot write sentences

Part B Spoken Chinese

1. I have no knowledge of spoken Chinese whatsoever

2. I can understand basic Cantonese (or other Chinese dialect) when it is spoken and speak a few
words or basic sentences of that dialect myself, but Chinese is not my mother tongue.
3. I can speak a dialect of Chinese (i.e.
) reasonably well, but no Mandarin.
4. I have native or near-native fluency in Cantonese.
5. I can speak some Mandarin because I have studied it before for ______________(length of
time)
6 I can speak some Mandarin because I have picked it up from family members or by
watching films and TV programmes in Mandarin or with Mandarin subtitles.
7. I have basic conversational Mandarin because I come from ______________ (e.g. Malaysia),
where Mandarin is widely spoken
8. I have had some exposure to the language because I and/or my parents have lived in

___________________(e.g. China)

It is your responsibility to provide the Centre for Co-Curricular Studies with

accurate information as to the extent of your exposure to the language; if you fail
to do so, we reserve the right to move you to another more appropriate level or to
withdraw you from the course.
I hereby certify that the information I have provided is accurate to the best of my
knowledge and that the questions relating to me have been accurately and fully
answered and that I understand that I will be placed in the most appropriate group
accordingly.
Signature: ________________

Date:

________________

Page 2 of 3

THIS SECTION IS TO BE FILLED IN BY CENTRE STAFF ONLY

Meeting with coordinator required

Date of meeting: ________________

Comments following meeting:

Students records to be checked with Registry

Results:

Students choice approved: Yes / No

If no, recommendation:_____________________

Signature & date:

Humanities stamp

__________________________