Lab Orientation: Student Information Survey - Spring II, Wednesday, 01 March 2017
Name: 


A red asterisk (*) indicates required questions.

  1. What is your name? Please write your full name.*


  1. Where are you from? Please include your hometown and country.*


  1. This is my first time in the United States?*
    Yes
    No


  1. If you answered "NO" to question number 3, please write where you have been in the United States.*


  1. What do you like to do in your free time? *


  1. If you could travel to any country or countries in the world, where would you go and why do you want to visit this country or these countries?*


  1. What was the most interesting or surprising thing you observed about the United States when you first arrived? *


  1. What are your favorite foods?*


  1. What places would you most like to visit while in the United States?*


  1. As an English language learner, please rank the following language skills from easiest to hardest. In other words, which skill do you feel most comfortable with, and which skills do you feel you need to improve? Example: If you feel that you can speak with English speakers easily, you should select that skill as the easiest. If you have great difficulty in understanding English when you are reading, then you would rank this skill as the hardest or last on the question. *
        1 2 3 4
    Listening  
    Speaking  
    Reading  
    Writing  


  1. Writing Sample

    Please respond to the the following writing prompt. Please write at least two paragraphs, but preferably three. Do your best to use correct grammar, sentence structure, and spelling.

    Prompt: Write about a "first" in your life. For example, the first time you drove a car, or the first time you stayed home alone, or what and how you felt the first day you arrived in the United States. *






Gordon Jones
Adjunct Instructor of ESL
University of Evansville - Intensive English Center
Evansville, IN