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English as a Second Language Workshop Series Survey

Prince William Public Libraries is expanding English as a Second Language (ESOL) resources and job readiness programs with support from a Carnegie Corporation of New York grant. Your responses will help us design resources and programs that meet your needs and support your success at work and in the community. Thank you for your input.

1. What is your preferred language for receiving library communication? (Select one).

Please enter an 'other' value for this selection.

2. What is your native language? (Select one).

Please enter an 'other' value for this selection.

3. What language(s) do you usually use in the following environments?

With family members
With friends
With co-workers/classmates
At home
At work/school
Doing daily tasks
Other (please specify):

4. In what way(s) have you learned or studied English? (Select all that apply)

Immersion (immigrating to an English-speaking country)
Classroom instruction
Self-learning
Other (please specify): Please enter an 'other' value for this selection. * This question is required.

5. On a scale of 1 to 5, how confident are you using the following skills in English?

1 - Not at all Confident
2 - Somewhat Confident
3 – Neutral/Not Sure
4 - Confident
5 - Very Confident

Space Cell	1	2	3	4	5
Listening	Listening: 1	Listening: 2	Listening: 3	Listening: 4	Listening: 5
Speaking	Speaking: 1	Speaking: 2	Speaking: 3	Speaking: 4	Speaking: 5
Reading	Reading: 1	Reading: 2	Reading: 3	Reading: 4	Reading: 5
Writing	Writing: 1	Writing: 2	Writing: 3	Writing: 4	Writing: 5

6. Which best describes your current job or employment status? (Select all that apply)

I am looking for a job that requires English.
I need to improve my English for my job or school.
I want to improve my English for daily tasks (e.g., navigating public transportation, going to the grocery store, asking for help).
Other (please specify): Please enter an 'other' value for this selection. * This question is required.

7. Which of the following are you interested in learning about? (Select all that apply)

8. Do you have any specific needs related to using English? Please explain in the space below.

9. If you are interested in being contacted for upcoming ESOL programs, please provide your contact information.

Name:

Email: This question requires a valid email address.

Phone: