Student Intake form
Please fill out this form so I can create a syllabus for our English Course.
Elementary school student
High school student
Finished your studies
How many lessons do you want per week?
1 x 60 minutes
2 x 60 minutes
1 x 90 minutes
2 x 90 minutes
3 x 60 minutes
What days / times do you want lessons?
Recommended setup for online lessons:
A minimum internet download speed of 3 Mbps
A minimum internet upload speed of 1 Mbps
An ethernet/LAN cable connection to a router
Headset with microphone
What is your internet Download speed
What is your internet Upload speed?
Which of the following voice/video can you use on your computer?
When did you last take an English course? What was your level?
Why is learning English important for you now?
I want to take an exam (CAE, TOEFL, etc.)
I need English for my job
I want to learn English for traveling
I need English for University studies
What is your job? (If you are a student, what do you study?)
What is the most important for you?
What is the 2nd most important for you?
What is the 3rd most important for you?
Choose 2 items that are the LEAST important for you
How often would you like to be corrected in a class?
0 corrections - I don't want any corrections. Being corrected annoys me. I only want to practise and study
1-5 corrections - Only correct me when I absolutely need it
6 - 15 corrections - My priority is to fix my errors
As much as possible - I love being corrected
In what situations do you WANT or NEED to speak English?
with the local community
at local shops
when traveling abroad
to meet people
What themes would you like to study in the course? (check all that you like)
Food & cooking
Health & exercise
Are you interested in doing English homework outside of class? Check all that you want.
listening comprehension exercises
reading comprehension exercises
Do you need extra help from the teacher outside of class time? For what?
email review & correction
CV & Cover Letter review & correction
Academic paper review & correction
other document review & correction
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