Result (E.g. IELTS, TOEFL, Cambridge)
Beginner Elementary Pre-Intermediate Intermediate Upper Intermediate Advanced
Did you study at secondary level (Junior high school, high school etc) or higher for 4 or more years? YES NO
1. Do you like children? Yes No 2. Do you smoke? Yes No 3. Do you like animals? Yes No 4. Do you follow a special diet? Yes No If yes, please explain: 5. Do you suffer from any allergies? Yes No If yes, please explain 6. Do you have any medical problems or take medication? Yes No If yes, please explain: 7. What are your hobbies or interests?