Student needs assessment form

This assessment helps AFI English understand who you are as a learner and how we can support your goals. By sharing your background, learning preferences, current English level, and objectives, you help us create a personalized learning plan that matches your needs, pace, and interests. Your answers guide your instructor in designing lessons, selecting materials, and providing feedback in a way that is most effective, comfortable, and motivating for you. This form ensures that your learning experience is tailored, intentional, and focused on the real-world results you want.

Please complete the student needs assessment form below.

Student needs assessment form

Basic information

First name

Last name

Preferred contact method

Call

Text

Other

Phone

Age

I am 18 years or older

Which country are you from?

What is your primary language?

What do you do for work?

Are you currently in school?

What is your highest level of education?

Primary school

High school

Some college/university or trade/vocational school

Certificate/professional diploma

Two year degree (Associates)

University/college graduate. (four year undergraduate/Bachelor's degree)

Master's degree/Professional degree (MA, MS, LLB, LLM, MD, JD, etc.)

PhD/Doctorate (research/professional)

Other

How long have you studied English?

Background information

Where have you studied English?

How would you rate your current English level?

A1 (Beginner) Example: "My name is Anna.” / “Where is the bus?” They can speak in simple words and memorized phrases. Survival English only.

A2 (Elementary) Example: “I went to the market yesterday.” / “I need to book a doctor’s appointment.” They can handle simple daily tasks and short conversations but struggle with detail.

B1 (Intermediate) Example: “I can explain my job, my routine, and my plans for next week.” They can hold everyday conversations, express opinions simply, and manage travel situations.

B2 (Upper-Intermediate)Example: “I can discuss complex issues like workplace problems or cultural differences, even if I need to pause to find the right words.” They understand native speakers at natural speed most of the time and can debate comfortably.

C1 (Advanced) Example: “I can present complex ideas clearly, negotiate professionally, and understand nuance, humour, and implicit meaning.” They function almost like a native professional.

C2 (Proficient) Example: “I can analyse detailed academic texts, shift tone intentionally, and adapt my language to any situation.” Near-native mastery; flexible, precise, and natural in all context.

Not sure

Short guide for students:

If you can only use basic phrases = A1/A2.

If you can speak comfortably about real life topics = B1/B2.

If you can debate, present, or write like a professional = C1/C2.

Motivations and goals

Why do you want to learn English & what are your English goals or motivation for learning?

What specific goals do you have for the next 3–6 months? (Example: speak confidently in meetings, understand native speakers, pass IELTS, etc.)

What are your long-term English or life goals?

Learning style and preference

What type of learner are you? (check all that apply)

Visual Learner “I learn best when I SEE information.” Examples: You understand vocabulary faster when I see pictures. Grammar makes more sense when you use charts, diagrams, timelines, or color-coded examples. You remember things better when the teacher uses slides, images, or videos.

Auditory Learner “I learn best when I HEAR information.” Examples: Listening to stories, dialogues, podcasts, or the teacher’s explanation helps me remember new words. You learn pronunciation by hearing and repeating. You prefer discussion activities, speaking exercises, and oral feedback.

Reading/Writing Learner “I learn best by READING text and WRITING notes.” Examples: You like reading articles, worksheets, or texts to understand new grammar. Writing things down helps me remember vocabulary. You enjoy journals, written exercises, summaries, essays, or reading comprehension.

Kinesthetic Learner “I learn best by DOING something physically.” Examples: You like activities where you move, such as running dictations or matching cards. You learn well through games, role-plays, acting out situations, or using physical objects like letter tiles. You prefer interactive lessons where I can participate actively, not just listen.

Mixed / Not Sure “I learn in more than one way.” "i'm not sure how I learn best." Examples: Sometimes you need pictures. sometimes you need to listen. sometimes writing works best. You enjoy a combination of visual, speaking, reading, and hands-on activities. You're open to discovering what method works best through practice.

Other

How would you like the teacher to call on you in class?

Call on me often. I like lots of speaking practice

Call on me sometimes. Let me warm up first

Don’t call on me unexpectedly unless necessary; I prefer volunteering

I’m okay with any style

Other

Do you have any preferences for group classes? (select all that apply)

I prefer being grouped with students who are at a similar English learning level.

I prefer mixed-level groups.

I prefer students close to my age

I prefer a mix of ages

I prefer to be grouped with students of the same gender.

I prefer small groups (2–4 students)

I prefer larger groups (5–8 students)

No strong preference

Other

Time management and study time

Do you want homework?

How much time can you study outside of class each week?

0–1 hours

1–3 hours

3–5 hours

5+ hours

English learning needs

If applicable, what are your English needs for work/scool/career?

If applicable, what are your English needs for University/exams

What are your English needs in general?

Do you feel nervous speaking English?

Yes, very

Sometimes

Not really

Never

Challenges and barriers to learning

What is the biggest challenge you experience when speaking English?

Are there any classroom accommodations or preferences you’d like me to keep in mind? (examples: audio settings, visual support, pacing)

Tell us about yourself! (optional)

Is there anything you'd like your teacher to know about you? (goals, learning style, personality, background, etc.)

Please share only what you are comfortable with.

Do you have any questions for your teacher? (This helps us personalize your first lesson.)

What are your expectations for the course?

Is there anything else you'd like to share?

Media and content permission

Please tell us what types of content you give AFI English permission to use for marketing, training, or promotional materials (website, social media, brochures, etc.) **select all that apply*

I give permission for AFI English to use my profile photo

I give permission for AFI English to use screenshots or images of me from lessons

I give permission for AFI English to use video clips of my lessons

I give permission for AFI English to use audio recordings of my voice

I give permission for AFI English to use my written work or homework samples

I give permission for AFI English to share anonymized quotes or testimonials written by me

I prefer that my name NOT be used publicly. AFI may share my any of the above as long as my name is changed

I do NOT give permission for my image, voice, or content to be shared in any form

Parent authorization and information

“I am the parent/legal guardian/education institution responsible for this student. I have read and approve this form submission, and I authorize him/her to submit this student needs assessment and participate fully in AFI English programs and activities.”

Name of parent/legal guardian/employee of institution

Relationship to student

Phone number of parent/legal guardian/institution

preferred contact method

Call

Text

Uma F luência aplicada internacional .

"Inglês que funciona, onde quer que você esteja."

Student needs assessment form

Please complete the student needs assessment form below.

Student needs assessment form

‪(307) 254-9454‬