First Day Information Sheet

Name: __________________________________________

1. Is English your second (or third or fourth, etc) language? ____________________________________

2. What is your first language (the language you spoke at home as a child)? ___________________

3. Where were you born?____________________

4. Tell me a little bit about your previous schooling and education.

5. Tell me a bit about your English language study.  Where have you studied English and for how long?

6. How did you learn English?

	A lot	Some	A little	None
Studying grammar
Listening to English speakers
Practicing with language tapes
Reading English literature
Watching US movies
Watching US television or listening to US radio
Other:

7. How do you use your languages?  Please complete the chart below.  Do not include 8. languages you only studied in school as a required subject, but only languages you use regularly.  For each category, fill in 1 = well; 2=some; or 3=not much.

Language	Understand	Speak	Read	Write
1. English
2.
3.
4.

9. Overall, what is your best language? _____________________________

10. How do you feel about reading and writing in English?  Use words such as confident, ok, anxious, terrible. 

11. What do you think your greatest needs or weaknesses in reading and writing in English might be?

12. How would you evaluate your English language proficiency? 

	Excellent	Very Good	Average	Poor
Speaking
Listening
Reading
Writing
Grammar

13. How do you feel about reading and writing in your first language?  In general, do you enjoy reading and writing?

14. What are your specific goals for this class?

15. What should I know about you to help you achieve these goals? 

16. What immediate questions do you have for me?