Sample II-5: Intermediate Level Can-Do List for Self Assessment
Directions: Put a check mark (
)
in the box that best describes you. Put only one check for each
row.
| Here's what I can do. | I can do this. No problem. | I do OK most of the time, except when things are complicated. | This is a little difficult for me, but I can do it with some help from others. | This is very difficult for me. I can only do it with a lot of help from others. | I can't do this. No way. It's much too difficult. |
|---|---|---|---|---|---|
| Talk about my country and my city with a friend or neighbor | |||||
| Ask for directions on the street or ask where something is in a store | |||||
| Ask someone to speak more slowly or to say things in a different way | |||||
| Fill out a form (name, birthdate, address, phone) | |||||
| Explain about myself and my work in a job interview | |||||
| Understand the notes that my child’s teacher sends from school | |||||
| Figure out my phone bill or electricity bill | |||||
| Explain to the doctor in detail what’s wrong | |||||
| Pick a story in the newspaper and read it | |||||
| Understand the news on TV |
(Adapted from Holt & Van Duzer, 2000. Used with permission.)