Literacy Assessment

Encourage your student to write the answer to the questions in the space provided.  
Repeat that this is not a test, rather it is an assessment of their current level 
of proficiency.  They may answer the questions in English or their native tongue


1.  What is your name? ___________________________________________________________

2.  What is your address? ________________________________________________________

3.  Are you married? _____________________________________________________________
 
4.  How many children do you have? _______________________________________________

5.  Where were you born? _________________________________________________________
                                     (Write in Country)

6.  What day is today? ___________________________________________________________

7.  How long have you lived in this city? ________________________________________

8.  Do you have a job?  Where do you work? _______________________________________

9.  What kind of work do you do? _________________________________________________

10. What do you need to study? ___________________________________________________

11. Did you attend school in your native country? ________________________________

    How long? ____________________________________________________________________
                           (Write in years)

12. Have you studied English? ____________________________________________________

    How long? ____________________________________________________________________
                           (Write in years)

13. Why do you want to study English? ____________________________________________

14. What do you do in your spare time? ___________________________________________

15. Tell me something about your family. _________________________________________