Name __________________________ Date ______________________

1. Why do you need to learn more English? Please be specific. Give examples of situations that are difficult for you in English.
   
   
   
   
   
2. What specific areas of English would you like to improve before you leave this class?
   
   
   
3. When people speak English to you, how much do you understand? Check the amount.
   ___ everything ___most ___some ___a little ___very little
4. When you watch TV, how much do you understand? Check the amount.
   ___ everything ___most ___some ___a little ___very little
5. When you speak English, how much do other people understand?
   ___ everything ___most ___some ___a little ___very little
6. Order the skills that you need from 1 to 6. Number 1 is the most important and number 6 is the least important to you at this time. Please use each number only one time.
   • Reading
   • Writing
   • Listening
   • Speaking
   • Vocabulary
   • Pronunciation