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Initial Assessment


Instructions
Utilize the ten tabs above to navigate through the following questions so that I may better help you learn. Each question has a corresponding tab to fill out your appropriate answers. Keep in mind to formulate your responses with complete grammatical sentences.


Student Name

What is your name?


Student Origin

Where are you from?


Length of Study

How long have you studied English?


Linguistic History

How many languages and dialects do you know?


Problem Solving

Do you prefer mathematics or drawing?


Personal Interests

As a person, what do you like to do?


Motivation

Outside of language, what would you like to learn?


E-mail

If you really want me to respond to you, please supply your e-mail address.

e-mail address
 @ 

Acceptance

After I receive your completed form, you will need to arrange a time with me to evaluate your listening and speaking proficiency. Please have a headset (headphones with an attached microphone) ready for optimal audio quality. Now, submit your form and proceed to purchase your initial assessment below: $15 USD for 1 hour.


I verify that the information I am submitting about myself is accurate to the best of my knowledge and ability.






($15 USD for 1 hour)