Student Information form

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Please fill out this form so I can create an English Course specific to your needs.

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メールアドレス *

Full Name *

Today's Date

YYYY

Phone number *

City, Country

What is your job? (If you are a student, what do you study?)

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

選択を解除

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?

Skype

Facebook

Zoom

Discord

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

その他:

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

Speaking

Listening

Vocabulary

Grammar

Writing

reading

Test preparation

In a 60 minute class, how much time do you want to spend on conversation, discussion, and role plays?

10 minutes

20 minutes

30 minutes

45 minutes

60 minutes

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In a 60 minute class, how much time do you want to spend on guided activities, exercises, lectures, and explanations?

15 minutes

30 minutes

45 minutes

60 minutes

選択を解除

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

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In what situations do you WANT or NEED to speak English?

at work

with the local community

at local shops

when traveling abroad

to meet people

in emergencies

その他:

What themes would you like to study in the course? (check all that you like)

Work

Travel

Food & cooking

Health & exercise

Culture

Sport

Politics

The environment

Entertainment

その他:

Are you interested in doing English homework outside of class? Check all that you want.

listening comprehension exercises

reading comprehension exercises

vocabulary review

writing exercises

その他:

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