EJO Elizabeth Johnson Organisation

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Fill in your information as completely as possible in order to tailor your experience to your personal needs

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Contact Information:

Title: Mr. Mrs. Ms. Dr.

Firstname:

Lastname:

Email Address:

Confirm Email:

My occupation / study is:

I want to improve my English because:

Current English Knowledge:

1 = Not important, 2 = Important, 3 = Very important

My level of English is: Beginner  Elementary  Intermediate  Advanced

Did you study English at school? Yes No

If so for how many years?

Have you studied English since leaving school? Yes No

If so, where did you study and for how long? for

Do you use English on a regular basis? Yes   No   Occasionally  

Skills Development:

1 = Not important, 2 = Important, 3 = Very important

Which skills do you wish to concentrate on during your course?

Speaking: 1  2  3

Listening: 1  2  3

Reading: 1  2  3

Writing: 1  2  3

Practical Applications - Speaking / Listening:

1 = Not important, 2 = Important, 3 = Very important

Which of the following do you wish to practise?

Communication / Language Games: 1  2  3

Discussions: 1  2  3

Role Play:
(i.e. practising situations) 1  2  3

Pronunciation: 1  2  3

Listening Comprehension: 1  2  3

Social Conversation: 1  2  3

Using authentic material:
(TV, radio or video) 1  2  3

Examination Preparation: 1  2  3

Other:
(please specify)

Practical Applications- Reading / Writing:

1 = Not important, 2 = Important, 3 = Very important

Which of the following do you wish to practise?

Correspondence:
(letters, faxes, e-mail) 1  2  3

Understanding Newspapers, Magazines: 1  2  3

Writing:
(stories, essays, diaries, messages, descriptions) 1  2  3

Dictation: 1  2  3

Vocabulary: 1  2  3

Grammatical structures: 1  2  3

Other:
(please specify)