General Questions -- like name, rank and serial number

 

Firstname Lastname Gender (m/f)

Address City State Zip

Your Birthday: (enter mm/dd/yyyy)

Your Relationship Status:

Single Committed Relationship Married Divorced Widowed

If you are in a relationship:

Partner's Firstname Lastname

If you are married:

Your Wedding Date: (enter mm/dd/yyyy)

 

Lifestyle Questions -- like homes, cars and social life

 

I now live in a:

Home Condominium Apartment

I am happy in my present dwelling I want a different dwelling

 

I would really prefer to live in:

Country: State/Provence: City:

 

My present car is:

My dream car is:

 

My ideal social life: (select one choice from each category)

Vacations:

      I want twelve weeks of vacations every year

      I want at least a week a month of vacations

      I want a special 2 to 3 weeks and several one week trips

      I am happy with the vacations I take now

 

Dining Out:

      I want to dine out once a week or more

      I want to dine out twice a month or more

      I want to dine out much more than I do now

      I am happy with my current dining out

 

Parties:

      I want to go to lots of parties and host a few

      I want to go to lots of parties

      I want to host lots of parties

      I want to have occasional parties

      I am happy with my present party schedule

 

Entertainment:

      I want to attend lots of great shows and movies

      I want to attend lots of shows and concerts

      I want to attend more entertainments than I do now

      I am happy with my present entertainment schedule

 

Sports:

      I want to attend lots of sporting events -- season tickets

      I want to play lots of sports (Golf, Tennis, etc.)

      I want to attend and play lots of sports

      I am happy with my current sports activities

 

Hobbies:

      I want to pursue hobbies that are very important to me

      I want to increase my hobby activities considerably

      I want to increase my hobby activities a little

      I am happy with my current hobby pursuits

 

Family Events:

      I want lots of great family events and outings

      I want more family events than we have now

      I want less family events than we have now

      I am happy with our current family events

 

Quiet Times:

      I want many more quiet times with special people

      I want more time to relax alone and with special people

      I want more time for personal solitude

      I am content with the quiet times I now enjoy

 

Relationship Questions

      My current relationships are just about perfect

      I want to improve my relationship with my significant partner

      I want a new harmonious relationship

      I want to improve my relationships with other people

      My current relationships need lots of work

 

Questions about your purpose

"There is one thing in this world, which you must never forget to do.
Human beings come into this world to do particular work.
That work is their purpose, and each is specific to the person.
If you forget everything else and not this, there's nothing to
worry about. If you remember everything else and forget your
true work,then you will have done nothing in your life.”
-Rumi

 

General:

      I know my life purpose and I am passionate about it.

      I'm inspired by what I do and it benefits others.

      I'm enjoying my life and that's all that matters.

      I want to have a meaningful purpose for my life.

 

Work:

      My work is my mission. What I do is valuable and meaningful.

      My work benefits society. I enjoy it and I am appreciated for it.

      I dislike my job and I'm looking for something better.

      My work enables me to pursue my purpose outside of work.

 

Creative:

      I pursue creative projects with great passion.

      I enjoy creative projects and they enhance my life.

      I want to find the time and energy for creative projects.

      I want to find creative activities that I am passionate about.

      I am content to support the creativity of other people.

 

Learning:

      I am here to learn important lessons in life.

      I enjoy the experience of learning new ideas and skills.

      I learn so I can fulfill my purposes.

      I want to learn more so I can experience more in life.

 

Sharing:

      I am here to share my time and talents with others.

      I feel good when I share with others.

      I am not sure how I can best serve others with my talents.

      I will just show up and let the Universe determine the outcome.

 

Spiritual:

      I am a spiritual being in a human experience.

      I am actively seeking spiritual enlightenment.

      I live life fully and trust in my spiritual unfoldment.

      I want to believe there is a spiritual purpose for my life.

 

Questions about your service

"A person’s true wealth is the good he does in this world.”
-Mohammed

 

General:

      My life is making a difference in the world.

      Being of service is the greatest value in my life.

      I want to find my right place of service.

      "He also serves who only stands and waits." Milton

 

Work:

      My work is my service.

      I want my work to be more meaningful service.

      My work enables me to be of service in other ways.

 

Family:

      Serving my family is my greatest treasure.

      I want to be of greater service to my family.

      I focus on serving others outside of my immediate family.

 

Community:

      I am active in my community and serve in many ways.

      My community benefits as I serve in other ways.

      I want to be more active in serving my community.

 

The World:

      I am making a significant impact in serving the world.

      I serve the world through my work, family and community.

      I want to make a real difference in the world.

 

The Universe:

      I serve the Universe (God) with all my heart.

      I want to dedicate my life to the service of the Universe.

      I serve the Universe just by being part of it.

Your possible dreams

"Hold fast to your dreams, for without them life is a broken winged bird that cannot fly.”
- Langston Hughes

 

In the boxes below, list the three biggest dreams you can imagine -- no matter how impossible they might seem right now: