Student ID Number______________ Country ______________________ First Language ______________ Instructor ___________________

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Student ID Number______________

Country ______________________

First Language ______________

Instructor ___________________

Date ____________________

CCP Pre-Survey for ESL Students

We’d like to know how you feel about your listening and speaking skills. Your answers will not be used as part of your application. Your answers will not affect your application or participation in any way. Thank you for taking time to answer these questions.

Please answer each question on a scale of 1-5 as follows:

1. Strongly agree

2. Agree

3. Maybe

4. Disagree

5. Strongly Disagree

1. I am comfortable speaking in English to other students in my ESL class.

1. [ ] 2. [ ] 3. [ ] 4. [ ] 5. [ ]

2. I understand what my ESL teacher says.

1. [ ] 2. [ ] 3. [ ] 4. [ ] 5. [ ]

3. Native English speakers understand me when I speak English.

1. [ ] 2. [ ] 3. [ ] 4. [ ] 5. [ ]

4. I feel confident having a conversation with a native speaker of English.

1. [ ] 2. [ ] 3. [ ] 4. [ ] 5. [ ]

5. I am comfortable using English in my everyday life.

1. [ ] 2. [ ] 3. [ ] 4. [ ] 5. [ ]

6. I understand American culture.

1. [ ] 2. [ ] 3. [ ] 4. [ ] 5. [ ]

CCP De Anza College

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