SYD Signature Series
Exit this survey
1. Are you reinventing?
Thank you for participating in this exciting venture with me!
1
. Please check the areas where you are re-inventing and let me know if this is by choice or by circumstance. For example if you are reinventing your marriage (getting a divorce) and you don't want the divorce you would check "marriage under the column of circumstance."
If you want to explain more you can put that in the "other" box.
Choice
Circumstance
No Change
Marriage
*
Please check the areas where you are re-inventing and let me know if this is by choice or by circumstance. For example if you are reinventing your marriage (getting a divorce) and you don't want the divorce you would check "marriage under the column of circumstance." If you want to explain more you can put that in the "other" box. Marriage Choice
Marriage Circumstance
Marriage No Change
Family Situation
Family Situation Choice
Family Situation Circumstance
Family Situation No Change
Friendships
Friendships Choice
Friendships Circumstance
Friendships No Change
Social life
Social life Choice
Social life Circumstance
Social life No Change
Work Relationship
Work Relationship Choice
Work Relationship Circumstance
Work Relationship No Change
Career
Career Choice
Career Circumstance
Career No Change
Finances
Finances Choice
Finances Circumstance
Finances No Change
Identity
Identity Choice
Identity Circumstance
Identity No Change
Title/Position
Title/Position Choice
Title/Position Circumstance
Title/Position No Change
Relocating
Relocating Choice
Relocating Circumstance
Relocating No Change
Other (please specify)
2
. Please tell me how you would describe yourself. Please check the one answer closest to the truth as you see it.
I am...
Please tell me how you would describe yourself. Please check the one answer closest to the truth as you see it. I am...
An entrepreneur
A coach, speaker, consultant
A small business owner
Retired
An executive
A manager
Employed
A home maker
A college student
Other (please specify)
3
. What is your age and gender?
What is your age and gender?
female under 35
female 36-42
female 42-49
female 49+
male under 35
male 36-42
male 42-49
male 49+
Mind Your own business :-)
4
. What industry are you in?
What industry are you in?
Performing Arts
Advertising/Marketing
Artist
Legal
Media
Non Profit
Internet Marketing
Medical
Speaking/Consulting/Coaching
Service Industry (Plumber, Electrician, Landscaping)
Telecommunications
Government
Manufacturing
Banking/Financial
Other (please specify)
5
. What is your biggest question about the book or about success in general? (If you can't think of any, please answer the question, "If there were no limits I would..."
What is your biggest question about the book or about success in general? (If you can't think of any, please answer the question, "If there were no limits I would..."
6
. Do you feel that there is something missing, or something holding you back from reaching your potential? For example do you suffer from low self-esteem? Do you feel that your spouse does not support you, or are you afraid to make changes? There are no right or wrong answers...just feel free to express how you feel in this place and time.
Do you feel that there is something missing, or something holding you back from reaching your potential? For example do you suffer from low self-esteem? Do you feel that your spouse does not support you, or are you afraid to make changes? There are no right or wrong answers...just feel free to express how you feel in this place and time.
7
. I'm planning an offering to take a select group of people from different backgrounds through my "Stop Your Drama" Signature process over a period of 8-12 weeks. This will be done over through a limited group coaching membership.
If you would be interested in applying for admission, let me know what would work with your schedule. If all times would work please
I'm planning an offering to take a select group of people from different backgrounds through my "Stop Your Drama" Signature process over a period of 8-12 weeks. This will be done over through a limited group coaching membership. If you would be interested in applying for admission, let me know what would work with your schedule. If all times would work please
Mondays 2:00 PM CDT
Mondays 8:00 PM CDT
Wednesdays 12:00 PM CDT
Wednesdays 7:00 PM
Time is not an issue
8
. This question is about how comfortable you are investing in your own personal growth. (Please do not consider the times your company has paid for you to go to a seminar.)
Although you are to be commended for investing "time" this question is about the financial investments you have made to your own development.
This question is about how comfortable you are investing in your own personal growth. (Please do not consider the times your company has paid for you to go to a seminar.) Although you are to be commended for investing "time" this question is about the financial investments you have made to your own development.
I have invested from $1000 to $2500 in my own growth.
I have invested from $500 to $1000 in my growth.
I have invested from $100 to $500 in my own growth
I have invested less than $100 in my own growth.
I never invest in my own growth.
9
. If all things considered, you feel that the limited term group coaching program is a good fit for you, what might hold you back from applying for a spot in the program? (Please tell me more in the comment box.)
If all things considered, you feel that the limited term group coaching program is a good fit for you, what might hold you back from applying for a spot in the program? (Please tell me more in the comment box.)
Not the right time slot.
Too many things on my plate.
The price is not affordable.
Too many people being admitted.
Would prefer one-on-one coaching
I've tried too many things that didn't work.
Other (please specify)
10
. If you are interested in asking your question in person on the "Meet the Author" call being conducted on January 14th, I will want to make sure I have your contact information to prep you for the call. Otherwise you may leave this section blank.
If you are interested in asking your question in person on the "Meet the Author" call being conducted on January 14th, I will want to make sure I have your contact information to prep you for the call. Otherwise you may leave this section blank.
Name:
Company:
Address:
Address 2:
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP/Postal Code:
Country:
Email Address:
Phone Number:
Powered by
SurveyMonkey
Create your own
free online survey
now!
Javascript is required for this site to function, please enable.