Name: Address: Telephone number: Email: Date of birth: Where are you from? What level of education have you had? (circle any) school, college, university, other... What is your profession or area of study? What are your hobbies? What language/s do you speak: What is your approximate level of English: When did you start learning English? Why are you learning English? (circle any) travel, work, studies, other... Which area of English do you want to improve the most? What, for you, makes a teacher a good teacher? What do you like doing in class? (circle any) listening, games, writing, grammar, reading, vocabulary, speaking, other... What don't you like doing in class? (circle any) listening, games, writing, grammar, reading, vocabulary, speaking, other... Any other comments (optional):