Preferable Start Date:        

Preferable End Date:          

Your current English level:

. Absolute Beginner Beginner Intermediate Advanced

What is your education level? . Under High School High School College University Post University Degree Bachelor Degree Master Degree Other  

If Other Describe:

What do you want to use you English for? . For Business For Work For Continue Education For Pleasure

Do you go to a language school now? 

Yes No

Did you take English lessons at school? 

Yes No

Did you take English courses before?

Yes No

Have you ever been aboard to study a language before? Yes No

Do you have any English speaking friends?

Yes No

How often do you speak English? 

Whole Day Once a DayOnce a week 

Once a monthNever

How much will you use English after you learn it? Whole Day Once a DayOnce a week 

Once a monthNever

What type of weather do you like?

Hot WarmCool Cold

Do you live with your mother and father now?

Yes No

Do you like children? 

Yes No

Do you have brothers and sisters? 

Yes No

Do you live in a house or an apartment? 

House Apartment

Do you smoke?

Yes No

Do you mind if other people smoke where you live?

Yes No

Do you drink beer?

Yes No

Do you have a pet?

Yes No

Do you mind living with a pet?

Yes No

Do you have any allergies?

Yes No

Do you plan to drive in the USA?

Yes No

Do you like computers?

Yes No

Do you want your school to have Internet access? 

Yes No