World English Placement Test Package - Cengage Learning

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PERSONAL DATA FORM Today’s Date: _______________ Name: _____________________________________________________________ Last First Middle Initial School: ____________________________________________________________ Home Address: ___________________________________________________________________ Number Street Apartment Number ___________________________________________________________________ City or Town State Postal Code Telephone: _________________ Home ________________ Cell For emergencies, call: _______________________ ________________ Name Telephone Number Birth Date: ____________________ Month/Day/Year Age: _______________ Signature of Student: ________________________________________ The student completed this form: (Circle one) Alone With assistance Signature of person helping student provide information: ___________________ 6 World English Placement Test Package Photocopiable © 2011 Heinle, Cengage Learning
NEEDS ASSESSMENT SURVEY 1. In your language, are reading and writing easy or difficult for you ______________ 2. How did you learn to read and write (Circle one.) school family tutor 3. Years of education: (Circle last year completed.) 5 6 7 8 9 10 11 12 13 14 15 16 (elementary) (secondary) (university) 4. Other education: _______________________________________________________ 5. Other languages you speak: ______________________________________________ 6. Other languages you read or write: ________________________________________ 7. What type of materials do you like to read in your language ___________________ 8. What do you write in your language (Circle one.) letters stories lists notes other 9. Have you studied English before __________ Where _______________________ 10. How long have you studied English ______________________________________ 11. Describe your ability in English: (Circle the best description.) Understanding is . . . always difficult sometimes difficult never difficult Speaking is . . . always difficult sometimes difficult never difficult Reading is . . . always difficult sometimes difficult never difficult Writing is . . . always difficult sometimes difficult never difficult 12. Why do you want to learn English ________________________________________ 13. What is the most important thing you want to learn __________________________ ________________________________________________________________________ 14. Do you have any questions about this program ______________________________ ________________________________________________________________________ The student completed this form: (Circle one.) Alone With assistance Signature of person helping student provide information: ___________________ 7 World English Placement Test Package Photocopiable © 2011 Heinle, Cengage Learning
Page 1 and 2: World English Placement Test Packag
Page 3 and 4: Contents Introduction to the World
Page 5 and 6: TEST ADMINISTRATION AND SCORING The
Page 7: Writing Placement Test Administrati
Page 11 and 12: Name: _____________________________
Page 13 and 14: Name: _____________________________
Page 15 and 16: Name: _____________________________
Page 17 and 18: ANSWER KEY 1. b 15. c 29. a 43. b 5
Page 19 and 20: Name: _____________________________
Page 21 and 22: Name: _____________________________

World English Placement Test Package - Cengage Learning

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