Module 2 Sample Needs Analysis
Questionnaire: Setting Goals and Thinking about Learning
Student name: __________________________________
1. Think about why you study English and circle the as many options as you think match your goals.
• Travel abroad
• Get to know various foreign cultures/peoples
• Learn about the English-speaking world
• Have better employment opportunities
• Work abroad
• Pass the final exams and get a degree
• Get better educated in general
• Enjoy my favorite books, songs, films, and TV shows
2. Circle two options. If you want, you can write in other ideas in the “Other” blank. During this course,
the two things I want to improve most about my English are:
• Grammar
• Vocabulary
• Writing skills
• Reading skills
• Other (please list): ____________________________
3. Circle up to three options. If you want, you can write in another idea in the “Other” blank. Topics I like
to discuss or learn about:
• Technology - for example __________________________
• Music - for example __________________________
• Sports - for example __________________________
• Art - for example __________________________
• Fashion - for example __________________________
• TV and movies - for example __________________________
• Environmental issues - for example __________________________
• Current Events - for example __________________________
• History - for example __________________________
• Other (please list): _______________________________________________________________
4. Circle one answer. During class, I like activities where I work…
• alone.
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• with a partner.
• with a team or group.
• some alone work/some group work.
5. Circle your answers. You can circle more than one answer. I like to learn by…
• watching videos.
• making videos.
• doing activities that involve moving my body.
• talking with others.
• writing.
• creating.
• working with computers.
• listening to music.
• playing games.
• other (please list): _____________________________________________
6. Circle up to four options to complete the sentence. Put an ‘X’ next to the option that is most
important to you. It’s important to me that my English teachers…
• use different types of materials (videos, music, Internet resources, books).
• ask me to use problem-solving skills.
• encourage class members to work together.
• make learning relate to my life and interests.
• explain instructions clearly.
• make learning challenging.
• make learning fun (games, puzzles, humor).
• let me make choices during activities and projects.
• help me discover things on my own.
• tell me how to improve my work.
• tell me when I am doing good work.
• let me be creative.
• are excited about teaching English.
• are friendly and encouraging.
• share their experiences learning English.
• are fair with class rules and grades.
• explain why we are doing something.
• other (please list): ______________________________________________________
Thank you for sharing some information with your teacher! This will help prepare the class in a way that
works for you and all other students.
Is there anything else you would like your teacher to know?
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