Dream Doer League Survey

1. Unshakable confidence. Unbreakable dreams. Unstoppable success.

Please fill out the following survey as completely and honestly as possible so I can help you find a way to live your dreams.

1. How old are you? What is your gender?

	AGE	GENDER
Basic Information	How old are you? What is your gender? Basic Information AGE	GENDER

2. What is your BIG DREAM? In other words, who do you want to be? What do you want to do? What does success look like for you?

What is your BIG DREAM? In other words, who do you want to be? What do you want to do? What does success look like for you?

3. What is the biggest challenge or obstacle standing in the way of your dreams right now?

What is the biggest challenge or obstacle standing in the way of your dreams right now?

4. Do you believe your dreams are possible?

Do you believe your dreams are possible? Yes

Maybe

5. If someone offered you a blueprint for achieving unstoppable success NOW (because you don't have to wait until you're 'grown up' to succeed), what format would you like the blueprint in?

If someone offered you a blueprint for achieving unstoppable success NOW (because you don't have to wait until you're 'grown up' to succeed), what format would you like the blueprint in? eBook

CD or Audio for iPod

DVD or Video for iPod

Webinar

Live Seminar/Workshop

Personal One-on-One Coaching

Other (please specify)

6. How many hours each week do you spend on the following activities?

	0	Less than 1	1-3	4-6	7-9	10 or more
Sports	*How many hours each week do you spend on the following activities? Sports 0	Sports Less than 1	Sports 1-3	Sports 4-6	Sports 7-9	Sports 10 or more
Facebook	Facebook 0	Facebook Less than 1	Facebook 1-3	Facebook 4-6	Facebook 7-9	Facebook 10 or more
Texting	Texting 0	Texting Less than 1	Texting 1-3	Texting 4-6	Texting 7-9	Texting 10 or more
Email	Email 0	Email Less than 1	Email 1-3	Email 4-6	Email 7-9	Email 10 or more
Watching Television/Movies	Watching Television/Movies 0	Watching Television/Movies Less than 1	Watching Television/Movies 1-3	Watching Television/Movies 4-6	Watching Television/Movies 7-9	Watching Television/Movies 10 or more
Watching YouTube Videos	Watching YouTube Videos 0	Watching YouTube Videos Less than 1	Watching YouTube Videos 1-3	Watching YouTube Videos 4-6	Watching YouTube Videos 7-9	Watching YouTube Videos 10 or more
Playing Video Games	Playing Video Games 0	Playing Video Games Less than 1	Playing Video Games 1-3	Playing Video Games 4-6	Playing Video Games 7-9	Playing Video Games 10 or more
Reading for Fun (not for school)	Reading for Fun (not for school) 0	Reading for Fun (not for school) Less than 1	Reading for Fun (not for school) 1-3	Reading for Fun (not for school) 4-6	Reading for Fun (not for school) 7-9	Reading for Fun (not for school) 10 or more
Listening to iPod	Listening to iPod 0	Listening to iPod Less than 1	Listening to iPod 1-3	Listening to iPod 4-6	Listening to iPod 7-9	Listening to iPod 10 or more
Homework	Homework 0	Homework Less than 1	Homework 1-3	Homework 4-6	Homework 7-9	Homework 10 or more

Other (please specify)

7. Do you ever feel like you can't be yourself, like you have to hide who you truly are and what you want so that you can fit in with your friends?

Do you ever feel like you can't be yourself, like you have to hide who you truly are and what you want so that you can fit in with your friends? All the Time

Sometimes (depends which friends I'm with)

Never

8. Do you know what your God-given talents (your strengths) are?

Do you know what your God-given talents (your strengths) are? Yes

9. Do you set written goals for yourself?

Do you set written goals for yourself? Yes

10. Do you want to learn how to set and achieve goals that allow you to be yourself and use your talents to live your dreams?

Do you want to learn how to set and achieve goals that allow you to be yourself and use your talents to live your dreams? Yes