student self assessment form

English Banana.com
Schools
Student Self-Assessment Form
To be completed by students at the start of a new course:
Name: _____________________________________________ Date: _________________

1.

Why do you want to learn English?
____________________________________________________________________

2.

What languages can you speak and write?
____________________________________________________________________

3.

What is your first language?
____________________________________________________________________

4.

Have you studied English before? (If yes, when and where did you study?)
____________________________________________________________________

5.

What was the highest level you achieved?
____________________________________________________________________

6.

Do you read English language magazines and/or books at home?
(If yes, which ones?)
____________________________________________________________________

7.

Do you watch English language TV programmes and/or listen to English language
radio programmes? (If yes, which ones?)
____________________________________________________________________

8.

Do you prefer reading practice, writing practice or speaking and listening practice?
____________________________________________________________________

9.

10.

Write GOOD, OK, or BAD under each skill below to show what you think of your
abilities at the moment:
Reading:

Writing:

Speaking:

Listening:

_________

_________

_________

_________

What do you want to gain from doing this course?
____________________________________________________________________

English Banana Schools