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Appendix A

QUESTIONNAIRE ON LANGUAGE USE

Conference Form

Name: Date:

What activities are most helpful to your English learning? (circle all that apply)

conversation games grammar practice listening to tapes

pair/group work reading songs pronunciation drills
writing videos other:_______________________

Where do you want to speak better English? (circle all that apply)

at work on the bus/train at the doctors on the telephone

in stores with friends with neighbors at your childrens school
other:_____________________

Do you want to read better English for.? (circle all that apply)
checks bills work notices forms maps/directions
job applications your childrens report cards/school notes
other:_____________________

Do you want to write better English for.? (circle all that apply)
checks bills work notices forms maps/directions
job applications your childrens report cards/school notes
other:_____________________

My goals are to: (circle all that apply)

get a job get a better job get a diploma speak better read better
write better other:____________________
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I have problems with: (circle all the apply)

pronunciation writing grammar American culture reading
conversation/speaking listening other:________________________

Do you prefer instruction in English only or bilingual instruction?

When do you prefer English only instruction? (circle all the apply)

pronunciation writing grammar American culture reading

conversation/speaking listening other:________________________

When do you prefer bilingual instruction? (circle all the apply)

pronunciation writing grammar American culture reading

conversation/speaking listening other:________________________

Personal information questions:

What is your race or ethnicity?
American Indian or Alaskan Native Native Hawaiian or Other Pacific Islander
Asian African-American Hispanic or Latino
other:___________________

What is your highest level of education?

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How old are you? (circle one)

20-25 years old 26-29 years old 30-34 years old 35-39 years old
40-44 years old 45-49 years old 50-54 years old 55-59 years old
60-64 years old 65-69 years old 70-74 years old 75-79 years old
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Appendix B

NEEDS ASSESSMENT (Spanish Version)

Nombre: Fecha:

1. Cuando necesita usar el idioma ingles?

2. Que situaciones o lugares necesitas para hablar ingles?

3. Cual de los siguientes le gustaria atencion en nuestras clases de ingles? Por favor marque:

Leyendo Escritura Hablando Escuchando

4. Que quieres estudiar? Por favor marque:

Comunidad Salud Trabajo Alojamiento Dinero y Compras
Transporte

5. Mis metas son:

6. Tengo problemas con:

Pronunciacion Escritura Gramatica Leyendo Conversacion

7. Esta trabajando? Cual es tu trabajo?

8. Cualquier otra cosa que quisieras que yo supiera sobre ti?

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NEEDS ASSESSMENT (English Translation)

Name: Date:

1. When do you need to use the English language?

2. What situations or places do you need to speak English?

3. Which of the following would you like the focus of attention in our English classes? Please

mark: Reading Writing Speaking Listening

4. What would you like to study? Please mark?

Community Health Work Accommodations Money and Groceries

Transportation

5. My goals are:

6. I have problems with:

Pronunciation Writing Grammar Reading Conversations

7. Are you working? What is your job?

8. Anything else that you would like me to know about you?

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Appendix C

OBSERVATIONAL CHART

Date: Student: Student: Student: Student:

Time:

Checkmark each Task: Task: Task: Task:

time the following

occur:

Student asked for

Spanish translation

Student understood

English-only

instruction

Student responded in

Spanish (did not

know how to respond

in English)

Student responded in

English (was able to

respond with no

Spanish words)
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Student understood

English-only

directions