Level: Advanced 3

Spring 2015 Semester

English as a Second Language (ESL) Class
Needs Analysis
Part I: Personal Information/Language Background
1. Name (First Name, Last Name): ___________________________________
2. Nationality: _____________________ ; Native language: _____________________
3. Language(s) Other than English: _____________________________________________
4. Highest Educational Level: _________________ ; Major (if any): _________________
5. How long have you been studying English? Where?
________________________________________________________________________
6. How long have you lived in the U.S.? _____________________
7. What is your reason for studying English?
________________________________________________________________________
________________________________________________________________________
8. Approximately, what is the percentage (%) of your daily English usage? ________%
9. How many hours are you willing to devote to studying or reviewing English outside the
class per week? ___________ hour(s)/week
Part II: Self-Evaluation of Language Skills
1. Please indicate the level of each skill based on your perception of the skill
1 = Extremely Easy

2 = Easy

3 = Average

Skills

4 = Difficult

5 = Extremely Difficult

Perception of the Skill

Grammar

Listening

Reading

Writing

Speaking

Level: Advanced 3
Spring 2015 Semester
2. In terms of skill(s) you indicated as 4 and 5, which aspects of these skills do you find
especially difficult?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

3. How important is it for you to focus on the following?

1 = Not important

2 = Might be important

3 = Average

Skills

4 = Fairly Important

5 = Very Important

Importance of Skill

Grammar

Listening

Reading

Writing

Speaking

Vocabulary

Pronunciation

4. What is/are the skill(s) you would like to improve the most in this course? Why?
________________________________________________________________________
________________________________________________________________________

Level: Advanced 3
Spring 2015 Semester
Part III: Classroom/Teacher Expectation
1. Teacher Expectation
Please indicate the extent to which you agree or disagree with the following statements.
1 = Strongly Disagree

2 = Disagree

3 = No Opinion

4 = Agree

5 = Strongly Agree

Statements

Level of Rating Scale

I value a teacher who expect all classroom rules to be followed

I expect the teacher to provide feedback on my work, including the

progress of my language learning during the course
I value the teachers guidance and advice on my language goals

I prefer a teacher who is firm and serious rather than friendly and
smiley

2. Classroom Expectation
Please indicate the extent to which you agree or disagree with the following statements.
1 = Strongly Disagree

2 = Disagree

3 = No Opinion

4 = Agree

5 = Strongly Agree

Statements

Level of Rating Scale

I prefer working in small groups rather than pairs during the lesson

I prefer to sit and listen to the teacher rather than practice speaking
during the lesson
I feel nervous whenever I have to speak in front of the class; e.g. during
presentation, reporting answers, being called on
I feel confident whenever I produce the language in the classroom; e.g.
speaking with classmates, answering exercise questions

Part IV: Students Voice

1. Tell me about yourself. What else would you like the teacher to know more about you?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________