Portland Community College | Portland, Oregon

6/27 Questionnaire HW

Level 2    First Day Questionnaire    Homework due by Friday, June 27

Please answer these questions.  If you don’t know the answer, you can write, “I don’t know.”  Use complete sentences for #7-14.

 

1. What is your first name?  ____________________________________________________________________

 

2. What is your last name?  ___________________________________________________________________

 

3. What is your G number?  ___________________________________________________________________

 

4. What is your PCC email address?   _____________________________ ______________________________

 

5. What is your personal email address?  _____________________________ ___________________________

 

6. What is your phone number?  _____________________________ ___________________________________

 

7. Where were you born?  What other countries have you lived in?

_____________________________________________________________________________________________________________________________________________________________________________________________

    

8. When did you come to the United States?  

_____________________________________________________________________________________________________________________________________________________________________________________________

 

9. What languages do you speak, read, and write?

_____________________________________________________________________________________________________________________________________________________________________________________________

 

10. Did you finish high school in your country?  Did you finish university?  If you finished university, what did you study? (=What was your major?)

_____________________________________________________________________________________________________________________________________________________________________________________________

 

11. What was your job before you came to the United States?

______________________________________________________________________________________________________________________________________________________________________________________________

 

12. What is your job now?  Where do you work?  What hours do you work?  Do you speak English at work?

_____________________________________________________________________________________________________________________________________________________________________________________________

13. Why are you taking this class?  How will you use English in your work/school/personal life in the future?

______________________________________________________________________________________________________________________________________________________________________________________________

 

14. Do you live with your family in the United States?  Who do you live with?  Do you speak English at home?

______________________________________________________________________________________________________________________________________________________________________________________________

 

Optional:  Do you have any questions for Mark?  Do you have anything else you want to tell Mark?  Please write your questions and comments here:

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________