Student ID Number______________
Country ______________________
First Language ______________
Instructor ___________________
Date ____________________
CCP Pre-Survey for Non-ESL Students
We’d like to know how you feel about your listening and speaking habits. 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 enjoy having a conversation with a foreign student.
1. [ ] 2. [ ] 3. [ ] 4. [ ] 5. [ ]
2. I could start a conversation with a stranger from another country who speaks English
1. [ ] 2. [ ] 3. [ ] 4. [ ] 5. [ ]
3. I can explain myself to someone who is learning English.
1. [ ] 2. [ ] 3. [ ] 4. [ ] 5. [ ]
4. I understand some ways that American culture is different from other cultures.
1. [ ] 2. [ ] 3. [ ] 4. [ ] 5. [ ]
5. I can give another student some suggestions about succeeding at De Anza.
1. [ ] 2. [ ] 3. [ ] 4. [ ] 5. [ ]
6. I have experience helping a foreign student understand US culture.
1. [ ]
2. [ ]
CCP De Anza College
3. [ ]
4. [ ]
5. [ ]