Part A in What Situation Is English (Or Would English Be) Useful For You? Please Check The Appropriate Column

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Name :

Status : Student (English Academic / Non English Academic / senior/ junior/


elementary school)
Teachers
Employers
Parents
Others (_________________________________)

Instance :

Part A
In what situation is English (or would English be) useful for you?
Please check the appropriate column

Put this sign √ in what situation would English be useful for you.
Very Not
Num Questionnaire Useful
useful useful
A1. Buying ticket plane

A2. Go to abroad

A3. Watching Hollywood movies

A4. Teaching or learning something in school

A5. Communicating with friends

A6. Buying something in Indomart

A7. Guiding tourist in Tourism places

A8. Listening music

A9. Reading instruction in cosmetic product

A10. Visiting Bali

A11. Reading the Jakarta Post


A12. Chatting with foreigner in Yahoo Messenger

A13. Singing a song

A14. Reading your lesson

A15. Asking friends studying together

A16. Learning English in class

A17. Speaking to your lecturer

A18. Making passport

A19. Taking vacation in Australia

A20. Doing national examination

A21. Continuing study in University

A22. Doing Job interview

A23. Receiving email

A24. Knowing popular idol

A25. Watching sport news in television

A26. Connecting with facebook

A27. Searching something in google

A28. Using English with family members

A29. Operating computer

Please Explain:
Others
Part B
From the list above please choose five that are the most important for you. Write the
number below

Part C
If you already speak English, please indicate your present level of ability in English
C1. Basic (lower): very limited vocabulary, grammar, and pronunciation heavily influenced by
mother tongue.
C2. Basic (upper): wrong pronunciation, short conversation on a few predictable topics; survival
level knowledge of vocabulary, grammar, and idiom
C3. Intermediate (lower): communicate with English fluently but different topics, though still
some difficulty with vocabulary, idiom, grammar and pronunciation
C4. Intermediate (upper): can manage comfortably in familiar situations and with familiar topics,
though still some difficulty with vocabulary, idioms, grammar, and pronunciation.
C5. Advanced: able to converse fluently and naturally on most topics; little difficulty with
vocabulary, idioms, grammar, and pronunciation.
Please put this sign √ in box that indicating your present level of ability in English

C1. Basic (lower)

C2. Basic (upper)

C3. Intermediate (lower)

C4. Intermediate (upper)

C5. Advanced

C6. If you have studied English, please indicate under what circumstances.
a. I studied English in Formal education (elementary, junior high school, senior high
school and university)
b. I took English course
c. I studied with a private tutor
Other
C7. If you attended (English course, formal education and other), please indicate the length and
frequency of them.
Example:

Num Activities Frequency


1 Formal education
6 weeks 3 hours per 1 week

Num Activities Frequency


1 Formal education
weeks hours per week
2 English course

3 A private tutor

4 Other
____________

____________

C8. How useful was the formal education? (Please circle your choice.)

Very useful Somewhat useful Not useful

C9. How useful was the English course? (Please circle your choice.)

Very useful Somewhat useful Not useful

C10. How useful was the private tutoring? (Please circle your choice.)

Very useful Somewhat useful Not useful

C11. How useful was the …………………..? (Please circle your choice.)
Very useful Somewhat useful Not useful

C12. If you have used one or more textbooks, please indicate the name of each text and how are
useful or otherwise it was:

Very useful Not


Name of textbook
useful useful
1 Metode cepat menguasai
bahasa inggris √
2 ______________________

3 ______________________

4 ______________________

5 ______________________

C13. To what would you attribute your present level of ability in English?

Very useful Not


useful useful
1 I attended a useful course

2 I studied in formal education

3 I studied with a private tutor

4 I enjoy studying English


I need English for my job
5
Other
6 ________________________

C14. What activities or experiences were most helpful in your study of English? Please
elaborate.
Part D
If you have studied English before, but have since stopped studying English, please
complete part D below by checking the appropriate box
I have studied English before, but I stopped because of the following reason(s):
Very Somewhat Not
Situations
true true true
D1 I didn’t have time to study English again

D2 I felt that I was not making any progress

D3 There is no opportunities to use English in outside the


classroom
D4 The lesson were not useful because:
a. Difficult to communicate with English

b. Pronunciation problem

c. Many vocabulary that difficult to memorize

D5 The teacher did not know how to teach English

D6 I did not like the teaching methods used

D7 The materials were:


a. Uninteresting

b. Irrelevant to my needs

c. Too easy

d. _________________________
e. _________________________

D8 Other:
_________________________________________
_________________________________________
_________________________________________
Part E
Have you ever used the following activities in studying English? If you indicate yes, how
useful were they?

Activities Very Useful Not


Num
useful useful
Practicing conversation from a book or internet
E1
Free conversation with native speakers
E2
Free conversation with other learners of English
E3
Memorizing bilingual vocabulary lists.
E4
Studying English textbook at boarding house /
E5
home
Studying the grammar of English
E6
Studying English Pronunciation
E7
Using MP3 at boarding house / home
E8
Speaking English without making mistakes in
E9
grammar or pronunciation
Translating English text from newspaper or others
E10
Using dictionary
E11
Asking friends to fix your pronunciation
E12
Other:
_____________________________________________
_____________________________________________
_____________________________________________

Part F
In class or with a tutor, I would like my teacher to:
A
Num Activities No Good Best
little
F1 Practice before explaining new grammar points

F2 Correct my mistakes of grammar


F3 Correct my mistakes of diction

F4 Correct my mistakes of pronunciation

F5 Use Indonesian language and English

Part G
What are your feelings about English as a language?

Very Somewhat Not


Situations
true true true
G1 English is a language with a rich vocabulary

G2 English is a very difficult language

G3 English is a language where pronunciation is very


important
G5 English is a language with a lot of grammar

G6 English is a beautiful language

G7 English is a amazing language to learn

G8 English is a boring language to learn

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