Question Title

* 1. What is your age?

Question Title

* 2. What do you do? Please briefly describe your work.

Question Title

* 3. What do you read? (please be specific... favorite magazines, blogs or books)

Question Title

* 4. What is your annual income?

Question Title

* 5. Do you consider yourself successful in your career? Why or why not?

Question Title

* 6. Current relationship status: married, widowed, divorced, separated, dating, etc...?
If married or divorced, how many times have you been married?

Question Title

* 7. In finding and/or maintaining a relationship, what has been your greatest challenge?
Please be as descriptive as possible.

Question Title

* 8. What do you fear most about being in a committed relationship?
Please be as descriptive as possible.

Question Title

* 9. Based on your level of success, do you find it more or less difficult to maintain an authentic relationship?
Please be as descriptive as possible.

Question Title

* 10. Would you be willing to be interviewed for this project?
If so, please type your name and contact information.
If your responses fit the criteria I'm seeking, I will email or call you to schedule an interview. (Thank you!)

T