Needs Analysis

Instructors: Amanda Loy & Elizabeth Wan

Community English Program (CEP)
Level: Intermediate 1
Teachers College, Columbia University
Fall 2013

My name: ____________________________________________________________________________
Native Country & Language: _____________________________________________________________
Number of years I have studied English: ________

Number of years I have lived in the US: _________

Number of years of college/university study: _____

My major: ________________________________

Language(s) (other than English) that I use: _________________________________________________

Self-Assessment of English Language Skills
Directions: For each area listed below, place a check mark in the column that best describes your skill
level.
1 = Very Weak
2 = Weak
3 = Average
4 = Strong
5 = Very Strong
1

Reading
Writing
Listening
Speaking
Grammar
Vocabulary
How do you feel about
1 = Hate it
2 = Uncomfortable

3 = No preference

4 = Comfortable
3

working in groups
working in pairs
public speaking
using technology
Do you own or have access to any of the following? (check all that apply)
Computer

Laptop

Smartphone

Tablet (iPad)

Internet

5 = Love it
5

Needs Analysis

Instructors: Amanda Loy & Elizabeth Wan

How often do you access the internet?

Never

Less than 1 hr/wk

1-2 hrs/wk

2-3 hrs/wk

>3 hrs/wk

What topics interest you? (Check all that apply)

American culture

Social networking (i.e. Facebook)

Global issues

Business

Technology

Travel

Fashion

Sports

Cooking/food

Other: _____________________________________________________________________________

Why did you choose to enroll in this class?

What are your goals for this class? What do you hope to be able to accomplish?

List 3 personal activities that interest you. (Ex: Travel, Exercise, Eating)
1. ___________________________________________________________
2. ___________________________________________________________
3. ___________________________________________________________

Thank You!