Class:______________________________ Room: ________
Name: in Romaji ____________________________________ Student Number: _________________
          in Kanji __________________________________________ Blood type: ______________

1. What does your name mean? ____________________________________________________________
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2. Where do you live? With whom? _________________________________________________________
3. Have you studied English other than in Jr. & Sr. high school or this university?
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4. Have you been to any foreign countries? Where? Why? For how long?
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5. What club do you belong to, or belonged to, if any?
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6. What’re you into? (meaning, what are your hobbies or interests?)
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7. Have you done anything that required using English in Japan? Explain.
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8. Who was your English conversation teacher last year?
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9. Briefly comment on your English conversation class:
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10. Did you record or videotape your practice conversations?
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11. What did (or do) you think of recording or videotaping your conversations?
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12. What are some classroom activities that you especially like to do?
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13. What are some things you’d like to learn in class ? Or learn how to do?
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14. Are you a motivated student? If so, what motivates you?
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15. What do you like to do to improve your English outside of class?
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16. What do you think you want to be in the future?
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17. How is English part of your future goals?
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18. Is there anything else you think I should know about you?
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