All About You Survey

It's important that the messages you receive from me are relevant to you. Please tell me about yourself via this survey.

As a thank you, you'll receive the pdf version of "Write Advice - Inspirations, Tips and Thoughts for Leaders and Artists"

1. Employment

Employment Unemployed Student Individual Contributor	Self-Employed Manager Executive
Other (please specify)

2. Education

Education Some High School

High school

College

University/master

Doctor

Professor

Other

3. Income

	Broke										Wealthy
Where do you place yourself?	Income Where do you place yourself? Broke	Where do you place yourself?	Where do you place yourself?	Where do you place yourself?	Where do you place yourself?	Where do you place yourself?	Where do you place yourself?	Where do you place yourself?	Where do you place yourself?	Where do you place yourself?	Where do you place yourself? Wealthy

4. Age

Age 0-24

25-34

35-44

45-55

55+

5. News Source

News Source MSNBC	CNN	FOX
Other (please specify)

6. How Social Are You? Which social media channels do you use and how frequently?

	What's that?	No Way	Seldom	Sometimes	Often	Daily
Facebook	How Social Are You? Which social media channels do you use and how frequently? Facebook What's that?	Facebook No Way	Facebook Seldom	Facebook Sometimes	Facebook Often	Facebook Daily
Twitter	Twitter What's that?	Twitter No Way	Twitter Seldom	Twitter Sometimes	Twitter Often	Twitter Daily
LinkedIn	LinkedIn What's that?	LinkedIn No Way	LinkedIn Seldom	LinkedIn Sometimes	LinkedIn Often	LinkedIn Daily
YouTube	YouTube What's that?	YouTube No Way	YouTube Seldom	YouTube Sometimes	YouTube Often	YouTube Daily
MySpace	MySpace What's that?	MySpace No Way	MySpace Seldom	MySpace Sometimes	MySpace Often	MySpace Daily
StumbleUpon	StumbleUpon What's that?	StumbleUpon No Way	StumbleUpon Seldom	StumbleUpon Sometimes	StumbleUpon Often	StumbleUpon Daily
Tumblr	Tumblr What's that?	Tumblr No Way	Tumblr Seldom	Tumblr Sometimes	Tumblr Often	Tumblr Daily
Formspring	Formspring What's that?	Formspring No Way	Formspring Seldom	Formspring Sometimes	Formspring Often	Formspring Daily
Flickr	Flickr What's that?	Flickr No Way	Flickr Seldom	Flickr Sometimes	Flickr Often	Flickr Daily
Blogs	Blogs What's that?	Blogs No Way	Blogs Seldom	Blogs Sometimes	Blogs Often	Blogs Daily
Podcasts	Podcasts What's that?	Podcasts No Way	Podcasts Seldom	Podcasts Sometimes	Podcasts Often	Podcasts Daily

Other (please specify)

7. What's your biggest impediment to achieving your personal goals?

What's your biggest impediment to achieving your personal goals? Little Clarity (I don't have goals.)

Lack of Focus (I have too many goals.)

Time (No personal time available.)

Money (Not enough to get what I want.)

Fear (What happens if I succeed?)

8. Rate your current level of satisfaction the following areas of your life.

	Blah										Wicked Awesome
Financial	Rate your current level of satisfaction the following areas of your life. Financial Blah	Financial	Financial	Financial	Financial	Financial	Financial	Financial	Financial	Financial	Financial Wicked Awesome
Career	Career Blah	Career	Career	Career	Career	Career	Career	Career	Career	Career	Career Wicked Awesome
Health	Health Blah	Health	Health	Health	Health	Health	Health	Health	Health	Health	Health Wicked Awesome
Relationships	Relationships Blah	Relationships	Relationships	Relationships	Relationships	Relationships	Relationships	Relationships	Relationships	Relationships	Relationships Wicked Awesome
Recreation	Recreation Blah	Recreation	Recreation	Recreation	Recreation	Recreation	Recreation	Recreation	Recreation	Recreation	Recreation Wicked Awesome
Contribution	Contribution Blah	Contribution	Contribution	Contribution	Contribution	Contribution	Contribution	Contribution	Contribution	Contribution	Contribution Wicked Awesome
Personal	Personal Blah	Personal	Personal	Personal	Personal	Personal	Personal	Personal	Personal	Personal	Personal Wicked Awesome
Education	Education Blah	Education	Education	Education	Education	Education	Education	Education	Education	Education	Education Wicked Awesome

9. What is an unmet aspiration of yours?

What is an unmet aspiration of yours?

10. Please include your email address so the pdf book "Write Advice" can be sent to you.

Please include your email address so the pdf book "Write Advice" can be sent to you. Name:
Gender:
ZIP:
Email Address:

All About You
Exit this survey

1. About You

1. Employment

2. Education

3. Income

4. Age

5. News Source

6. How Social Are You? Which social media channels do you use and how frequently?

7. What's your biggest impediment to achieving your personal goals?

8. Rate your current level of satisfaction the following areas of your life.

9. What is an unmet aspiration of yours?

10. Please include your email address so the pdf book "Write Advice" can be sent to you.

All About YouExit this survey

1. About You

1. Employment

2. Education

3. Income

4. Age

5. News Source

6. How Social Are You? Which social media channels do you use and how frequently?

7. What's your biggest impediment to achieving your personal goals?

8. Rate your current level of satisfaction the following areas of your life.

9. What is an unmet aspiration of yours?

10. Please include your email address so the pdf book "Write Advice" can be sent to you.

All About You
Exit this survey