Language, Literacy and Numeracy (LLN) Assessment Questionnaire Form
Complete this questionnaire to help us understand your current language, literacy, and numeracy skills. Your responses will guide support and learning opportunities.
Full Name
*
First Name
Last Name
How confident do you feel about your language, literacy, and numeracy skills overall?
*
1
2
3
4
5
Please rate your skills in the following areas:
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Rows
Not Confident
Somewhat Confident
Confident
Very Confident
Reading and understanding written information
1
2
3
4
Writing clearly and accurately
5
6
7
8
Understanding spoken instructions
9
10
11
12
Speaking and expressing ideas
13
14
15
16
Using numbers in daily tasks
17
18
19
20
Which language do you most often speak at home?
*
How often do you read books, newspapers, or online articles?
*
Daily
Several times a week
Once a week
Less than once a week
How comfortable are you with basic math (e.g., addition, subtraction, multiplication, division)?
*
Not comfortable
1
2
3
4
Very comfortable
5
1 is Not comfortable, 5 is Very comfortable
Which statement best describes your ability to fill out forms or write emails?
*
I can do this easily without help
I can do this but sometimes need help
I need help most of the time
I cannot do this
In your daily life, how often do you need to use numbers (e.g., budgeting, shopping, measuring)?
*
Very often
Often
Sometimes
Rarely
Please write a few sentences describing a recent experience where you used reading, writing, or numeracy skills.
*
Are there any specific areas of language, literacy, or numeracy you would like to improve?
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