Questionnaire for the French Teacher

We ask your help in completing the following questionnaire, in order that we may place the student in an appropriate level of French at Loomis Chaffee. This questionnaire will be used for placement purposes only, as the student has already been accepted to our school. This is a confidential statement.

Please submit all questionnaires by May 22. Thank you for your help!

Name of Studentrequired

Name of Schoolrequired

School City and Staterequired

Name of Teacherrequired

Level (year) of French at present

Present mark

What section is the student in?

Honors Regular Other

If other, please specify:

Number of days class meets per week:

Length of class periods:

Does the class meet for the whole year?

Yes No

If no, please explain:

What is the full title of the current text used in class?

Author, date and editor

What is the level of current text?

How much of this text was completed?

Supplemental reading(s) (ex: poems, short stories, fables, current events)

Are audio-visual materials used in connection with this course?

In class?

Yes No

In lab?

Yes No

If yes, please list:

To what extent is French spoken in class?

Percent (%) by student

Percent (%) by teacher

Check this student's proficiency at his/her present course level below:

Oral

Excellent Good Average Poor

Comments

Written

Excellent Good Average Poor

Comments

Comprehension

Excellent Good Average Poor

Comments

How does this student learn and assimilate new French material?

very quickly and with great ease somewhat quickly and with some ease gradually and with some difficulty other

If other, please explain:

How well does the student generally comprehend and manipulate material once learned?

with great comfort and accuracy with some comfort and accuracy with hesitation and lack of accuracy other

If other, please explain:

How would you describe this student's motivation in your French classroom?

highly motivated; consistently exceeds expectations somewhat motivated; meets expectations not very motivated; falls short of expectations

How does this student speak French?

with comfort and accuracy other

If other, please explain:

Please describe this student's writing ability in French.

In each category below, please mark the verb tenses the student has mastered actively, passively, or N/A if student has yet to be introduced to this topic.

Active = student has mastered the application in producing the language correctly in speaking and in writing.
Passive = student recognizes patters of expression but has difficulty in producing the language correctly in either writing or speaking.

present

Active Passive N/A

futur

Active Passive N/A

futur proche / immediat

Active Passive N/A

imperatif

Active Passive N/A

passe compose avec etre

Active Passive N/A

passe compose avec avoir

Active Passive N/A

imparfait

Active Passive N/A

conditionel

Active Passive N/A

present du subjonctif

Active Passive N/A

participe present

Active Passive N/A

plus-que-parfait

Active Passive N/A

conditionel passe

Active Passive N/A

passe du subjonctif

Active Passive N/A

Please tell us what you consider to be the strengths and weaknesses of the student:

Has this student participated in the French National Exam (Le Grand Concours)?

Yes No

If yes, what level?

What was the student's score?

National ranking?

For how long have you been this student's teacher?

You agree that by typing your name below, you are electronically signing this form and declaring that the information you have provided is true and accurate.

Teacher Full Namerequired

Daterequired (mm/dd/yyyy)