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Objective: To evaluate the knowledge and the present situation you have about English
in order to design activities that will be helpful for you in terms of improving your level.
1. PERSONAL INFORMATION
Name: ______________________________________________________
Age: ___________________
E-mail: ______________________________________________________
2. ACADEMIC INFORMATION
Part A
What English skills do you think you have difficulties at? (Choose as many as you
consider)
a. Speaking c. Listening
b. Writing d. Reading
a. Speaking c. Listening
b. Writing d. Reading
a. Excellent d. Poor
b. Good e. Very poor
c. Regular
Please indicate your present level of ability in English
(mark with an X the most suitable answer)
a. Basic: very limited vocabulary, grammar,
pronunciation heavily influenced by
mother tongue, short conversation on a few predictable
topics.
Part B
Part C