Overview:
To accomplish our dreams and goals, we need to be wise stewards of our time, talents, treasures, and trust. There are natural laws that give those who are wise stewards greater happiness, more success, improved finances, and better relationships. Our goal for this tool is to help you reach beyond your dreams in every area of your life.
This Life Stewardship X-Ray will provide a baseline measurement to demonstrate how well you are doing in numerous areas of your life and outline steps for improvement. It is recommended that you take this X-Ray every three to six months to evaluate how you are progressing as a steward of your gifts.
For best results, work with a certified consultant. Our certified consultants have been through specialized training and mentoring and have first-hand experience in maximizing the benefits of this tool. They also have the ability to coach you to improve your success and overall life balance.
Steps To Accomplish:
If you want to accomplish your dreams and goals, you need to do the following four things:
1. Identify what your dreams and goals are.
2. Know what actions to take to achieve those dreams and goals.
3. Be willing to pay the price to complete those actions.
4. Achieve those actions and apply the 12 Principles For Life Management.
Life Evaluation X-Ray
This tool is designed to help you identify where your strengths and weaknesses are and what you value in each area of your life. It is designed to help you more fully understand the four following areas of stewardship:
1. Time: How do you invest the time you have been given? Being a good steward of your time is more important than money management because you can save money and use it later-- something you are unable to do with time.
2. Talents: We have all been given natural talents which we have had since birth, and it is our responsibility to share these talents with others. To prevent pride from destroying our lives, we need to understand and be thankful for those individuals currently in our lives as well as those in past generations who have made us what we are today. The investments others make in our lives cause us to seek more effective ways to use our talents for the good of others.
3. Treasure: We have all been gifted with financial resources. Even the poorest Americans are wealthy when compared to the poor in other areas of the world. The difference we can make in others' lives by consistently sharing just a little of our resources will bring joy to our lives and the lives of those we love.
4. Trust: We have all been gifted with special relationships. We need to show our appreciation for the investments others make in our lives and we need to be wise stewards of the trust they place in us. Others show their trust in us by their love, friendship, time, and relationships. When we violate the trust others have in us, we are being unwise stewards of one of most important assets-- people's lives!
Please fax completed X-Ray to analysis center: Toll Free (888)230-2301
Interview Date: ___, ___/___/____ Time: ___:___ Amount: $_______ S&H: $______ Total: $________
Name: ______________________________ Bill To: * Sponsored By * Add sponsor's name/logo to X-Ray if possible
E-mail: ______________________________ Company: _______________________________
Company: ____________________________ Address: ________________________________
Work Phone: (_______)_______-________ City: ___________________________________
Fax: (_______)_______-________ State: _____ Zip: _____________
____________________________________ * Check will be sent.
(Home Address) * Credit Card Number: _______________________
____________________, ___ ___________ Billing address: _____________________________
Home Phone: (_______)_______-________ Exp. Date: __/__ _________________________
Pager: (_______)_______-________ Sponsor (signature)
* Send via [ ]-Post Office-Priority, * Send via [ ]-Post Office-Priority,
[ ]UPS, [ ]-FedEx ( )-2 day, ( )-next day [ ]UPS, [ ]-FedEx ( )-2 day, ( )-next day
* Send client-to-client, * sponsor-to-sponsor, * Send client and sponsor's copy to sponsor for distribution.
* Use client's #: ____________________________________ [ ]UPS, [ ]-FedEx ( )-2 day, ( )-next day
[____]-Color X-Ray & questionnaire to [ ]-sponsor, [ ]-monthly book, [ ]-consultant, [ ]-______________
The Life Stewardship X-Ray has been designed to provide enough basic information about your life in written "snapshot" form. It also will assist you in identifying key areas where minimal effort can give you the best return on your investment of time and energy. While this evaluation is a good tool, it is not to be used as a replacement for a knowledgeable certified consultant who can fine-tune and factor in other areas that are difficult to measure via a limited, written evaluation model. For best results, review and analyze all information with a certified ActionVision consultant.
To complete the X-Ray, pages three and four are essential. The other information will provide additional detail, ideas, and information to make the X-Ray as comprehensive as possible. The more information you provide, the more accurate your personalized X-Ray will be. Please do not complete anything that makes you feel uncomfortable.
The pages after the X-Ray will assist you by walking through the process of what your dreams and goals are in each area and what ingredients are needed for success. Additional life tools are available through the Life Masteries Institute to help you achieve each of your dreams and goals by being the best steward of your talents and what others have entrusted to you. By being a great steward, you will achieve your full potential and enjoy the journey of life. For additional information, please talk to your certified consultant or call the Life Masteries Institute for additional learning resources.
Personality Insight: This and other Life Masteries Institute tools are extremely powerful and can help you work and interact with one another more effectively, identify strengths and weaknesses, learn what causes pain and pleasure, and understand how to function more effectively in all relationships. It will also provide insight into which personality types are attracted to your personality type and how other individuals will interact in a relationship. Ask for the personality trait analysis tool.
Analysis Center Use Only:
Presented By: ______________________ Certification Number: ___________
X-Ray Developed By: ______________________ Certification Number: ___________
Analysis Completed By: ______________________ Certification Number: ___________
Date X-Ray given: ___/___; Completed (pg. 1-5): ___/___, totally: ___/___; Submitted: ___/___ ___:____ am/pm
Consultant requested Date: ___/___, X-Ray sent: ___/___; Reviewed: ___/___, Next Action Faxed: ___/___
ActionVision interview date: ___/___/___; ActionVision plan submitted: ___/___/____
ActionVision plan completed: ___/___/___; Monthly reviews started: ___/___/____
Monthly AV reviews will be completed by: _____________________ Phone (____)____-_____ Cert. #: _______________
Monthly Contact: Jan:__, Feb:__, Mar:__, Apr:__, May:__, Jun:__, Jul:__, Aug:__, Sep:__, Oct:__, Nov:__, Dec:__
Completed By: ______, ______, ______, ______, ______, ______, ______, ______, ______, ______, ______, ______
Client Would Like Completed By: ___/___/____ Interview Date: ____, ___/___ Time: ____:____
Life Stewardship X-Ray - Please fax to analysis center: (630)393-9901
Your Name: _______________________ Date: __/__/____ Age: ___, <18, 18-25, 26-40, >40
For period from __/__/____ to __/__/____ *Yearly, *Quarterly, *Monthly
Phone: (______)______-_______ E-mail: _______________________________
Please rate yourself on a scale of 1 to 10 (10 indicates that you are doing everything you believe is necessary). On the first line __ please rate where you think you or your family member(s) are currently. In the box [___] please rate how important this area is (1 to 10 with 10 being very important) as it relates to the individual in that section.
A. Life Stewardship
___ [___] 1. I maximize the use of my time on a daily basis.
___ [___] 2. I carefully schedule my day.
___ [___] 3. I plan my day at least 24 hours in advance.
___ [___] 4. I understand the difference between good and great activities and invest my time in the great activities.
___ [___] 5. I tithe a portion of my time to others; I feel that I am making a difference with the time I invest.
___ [___] 6. I understand my own gifts and talents.
___ [___] 7. I have a life vision clearly articulated.
___ [___] 8. I use my gifts and talents on a daily basis for the accomplishment of my life dreams and goals.
___ [___] 9. I apply consistent effort to nurture my talents by sharing them with others.
___ [___] 10. I work with others to encourage them to find their talents and share them freely.
___ [___] 11. I believe I am in a position or career that is living up to my full potential and full earning power.
___ [___] 12. I have been a wise steward of the money I have earned.
___ [___] 13. I tithe on a consistent basis to my local place of worship.
___ [___] 14. I give back financially to my community and believe that it makes a difference in the community.
___ [___] 15. I am disciplined in saving and investing on a monthly basis .
___ [___] 16. I invest time into other people's lives.
___ [___] 17. I am respectful of my co-workers' time management needs.
___ [___] 18. I respect and support the differences of my family and friends.
___ [___] 19. I am making a difference in the lives of those I love.
___ [___] 20. I am happy with the amount and quality of time I invest into those I love the most.
_____ [____] Totals
B. I believe I have the ability to:
___ [___] 1. Develop and follow a written plan to achieve my maximum earning potential.
___ [___] 2. Perform necessary steps to earn my full potential even if I do not enjoy doing those steps in the short-term.
___ [___] 3. Learn, think, and act on my own to maximize my earnings within my current position.
___ [___] 4. Give financially to others based on my written plan.
___ [___] 5. Give to others financially even when I do not have enough for myself.
___ [___] 6. Be passionate about being the best steward of my financial gifts and confident that I am doing my best.
___ [___] 7. Follow my pre-determined written budget.
___ [___] 8. Postpone purchases until I have the ability to purchase with cash.
___ [___] 9. Be disciplined about every purchase to ensure wise stewardship on an hourly basis.
___ [___] 10. Follow my long-term written plan for savings, investing, and long-term needs.
___ [___] 11. Save a given amount of money every month.
___ [___] 12. Invest savings and then manage it on a regular basis.
_____ [____] Totals
A. What is the biggest challenge you are facing in any area of your life at this time?
B. What would be a big income goal for you to achieve over the next 12 months? _________
* < $26,000, * $26-$50,000 * $50-$100,000
* $100-$250,000, * >$250,000
C. My spouse has the ability to:
___ [___] 1. Develop and follow a written plan to achieve maximum earning potential.
___ [___] 2. Perform necessary steps to earn full income potential even if he/ she does not enjoy doing those steps in the short-term.
___ [___] 3. Learn, think, and act on his/ her own to maximize earnings within current position.
___ [___] 4. Give financially to others based on his/ her written plan.
___ [___] 5. Give to others financially even when he/ she does not have enough for him-/ herself.
___ [___] 6. Be passionate about being a good steward of financial gifts and confident that he/ she is doing his/ her best.
___ [___] 7. Follow his/ her pre-determined written budget.
___ [___] 8. Put purchases off until he/ she has the ability to purchase with cash.
___ [___] 9. Be disciplined about every purchase to ensure wise stewardship on an hourly basis.
___ [___] 10. Follow his/ her long-term written plan for savings, investing, and long-term needs.
___ [___] 11. Save a given amount of money every month.
___ [___] 12. Invest savings and then manage them on a regular basis.
_____ [____] Totals
D. My child(ren) has/ have the ability to:
___ [___] 1. Develop and follow a written plan to achieve their maximum earning potential.
___ [___] 2. Perform necessary steps to earn full potential income even if they do not enjoy taking those steps in the short-term.
___ [___] 3. Learn, think, and act on their own to maximize earnings within current position.
___ [___] 4. Give financially to others based on their written plan.
___ [___] 5. Give to others financially even when they do not have enough for themselves.
___ [___] 6. Be passionate about being a good steward of financial gifts and confident that they are doing their best.
___ [___] 7. Follow their pre-determined written budget.
___ [___] 8. Put purchases off until they have the ability to purchase with cash.
___ [___] 9. Be disciplined about every purchase to ensure wise stewardship on an hourly basis.
___ [___] 10. Follow their long-term written plan for savings, investing, and long-term needs.
___ [___] 11. Save a given amount of money every month.
___ [___] 12. Invest savings manage them on a regular basis.
_____ [____] Totals
E. My family is willing and able to:
___ [___] 1. Cut our budget to save for something long-term.
___ [___] 2. Understand the importance of compounding interest; we're willing to apply that principle.
___ [___] 3. Work together for common financial goals.
___ [___] 4. Follow a written budget.
___ [___] 5. Make small daily sacrifices to gain big things for the family in the long-term.
___ [___] 6. Use a detailed, written monthly budget and be accountable to four other individuals to maintain that budget.
___ [___] 7. Meet once a week to discuss how everyone is doing in general and to review everyone's personal financial responsibilities.
___ [___] 8. Make the necessary sacrifices in the short-term to achieve the long-term goals.
_____ [____] Totals
Which of the following would cause you the most frustration? Please rate them 1-4 (with 1 being most, 4 being least). Example: 3 A. 2 B. 4 C. 1 D.
___ A. Things being inaccurate or done incorrectly.
___ B. Things being out of control.
___ C. Things not being fun.
___ D. Conflict with others.
If you are in business:
A. How many hours do you currently work per week? ___
B. How many hours would you like to work per week? ___
C. If you had 10 leads (name & phone numbers), how many would turn into sales? _____
D. How many past clients do you have? __________
E. How many professional referral sources do you have? (e.g. other professionals that refer you business.)_____
Time Stewardship
In many ways, properly managing our time is more important than managing our money. We can save our money and spend it later, but we are unable to do that with time.
1. What is the biggest challenge you currently face in managing your time?
2. Where do you believe you are strongest in time management?
3. What is your greatest weakness in managing time?
4. Have you ever tracked where your time is being invested for a two-week period?
[ ]-Yes, [ ]-No
5. Are you willing to track where you invest your time for two weeks?
[ ]-Yes, [ ]-No
6. What is your greatest motivation to improve where you invest your time?
7. List one area of time management that you would like to improve over the next three months.
8. Please rate your level of satisfaction with the amount of time you invest in each the following areas: (1 to 10, 10 being the best.)
____ - Personal walk with God
____ - Spouse
____ - Children
____ - Family
____ - Loved ones
____ - Friends
____ - Career
____ - Church
____ - Community
____ - __________________
9. Please rate your level of satisfaction with the quality of time you invest in each the following:
____ - Personal walk with God
____ - Spouse
____ - Children
____ - Family
____ - Loved ones
____ - Friends
____ - Career
____ - Church
____ - Community
____ - __________________
10. If you continue to use your time in the same way you have over the last twelve months, what will your life be like in three, five, ten, or twenty years?
11. Name two people you respect that might be able to assist you in better time management.
12. List 3-4 actions that you need to take over the next twelve months to improve your stewardship of time.
a.
b.
c.
d.
Talent Stewardship
1. List your top five skills or natural talents.
2. Which two talents or skills are you not currently using to the best of your ability?
3. What is your big dream when you think about using your talents or skills?
4. What are the three most important steps you would like to take over the next twelve months to help you achieve your big dream?
a.
b.
c.
5. What do you are currently do in any area of your life that you enjoy?
6. What do you like most about your current career/ life vocation?
7. What do you like least about your current position/ life vocation?
8. What is your greatest area of strength in your career/ life vocation?
9. What is your greatest area of weakness in your career/ life vocation?
10. List one thing you could do to make yourself more valuable to your boss or your company.
11. What are your advancement goals in your current career, and what do you need to do to accomplish them?
12. If you were seeking another career or employer, what would you look for? Is there a way in which you could turn your current position into that dream position?
13. Please list the top three to four actions you need to take in your current position to be the best steward of your life.
a.
b.
c.
d.
Financial Stewardship
1. What is the biggest financial challenge you currently face?
2. What is your greatest strength in that financial area?
3. What is your greatest weakness in that financial area?
4. Do you have a written budget? ____
Do you follow that budget on a monthly basis? ____
5. What is/ are the most important, sizable long-term financial goal(s) that you would like to achieve over the next:
A. 12 months
B. 2 years
C. 5 years
6. What major areas in your spending habits do you believe you could manage more effectively, and how much money do you believe you could save monthly?
a. Save $___ monthly
b. Save $___ monthly
c. Save $___ monthly
7. What two disciplines do you need to accomplish daily in order to achieve your twelve-month goals?
a.
b.
8. Who could most effectively assist you in reaching your dreams and goals?
9. How will achieving your dreams and goals affect your loved ones?
10. List two or three long-term dreams
(5 to 20 years).
a.
b.
c.
11. What three things do you need to do over the next year to get closer to your financial dreams?
a.
b.
c.
12. What will you see, hear, feel, or experience when you have accomplished your big dreams and goals?
13. What good choices do you need to make to accomplish your big dreams and goals?
14. List two bad choices you could make that could destroy or hurt your dream.
A.
B.
15. List the two strongest financial skills your parents instilled in you that have assisted in financial management.
A.
B.
16. What are the two greatest financial weaknesses that your parents have that you may also have?
A.
B.
17. What were the most significant financial goals you have accomplished, and why were you able to accomplish them?
18. Who would provide you with the most encouragement and accountability to achieve your financial goals?
19. List 2-3 actions you believe you should take over the next twelve months that would help you to be a better steward of your finances.
a.
b.
c.
20. If you are married, what actions would you like to take over the next twelve months to improve the stewardship of your family's finances?
a.
b.
21. If you have children, what actions would you like to take to help the family (or individual child) improve the stewardship of finances?
a.
b.
Trust Stewardship
We have all been blessed with relationships. Some relationships are better than others, and there seems to be a direct correlation between how good a steward we are with our relationships and the strength of those relationships.
1. What do you value most in a relationship?
2. What relationship would you like to focus on improving the most over the next twelve months, and what actions you would like to take to accomplish this?
Relationship with __________________
a.
b.
c.
d.
3. In the past, what have you done to build and strengthen a relationship?
4. List the three most valuable and long-lasting relationships you have developed, and why you think those relationships have been so successful.
a.
b.
c.
5. What is your biggest motivation to significantly improve your stewardship with relationships over the next twelve months?
6. What is your biggest challenge in developing or maintaining great relationships?
7. Into what relationship(s) have you invested a great deal and received great benefit and why?
8. Into what relationship(s) have you invested a great deal without seeing the results you would have liked? Why do you think that occurred?
9. What have you seen others do in relationships that you would like to do if they would improve your relationships?
Business Information
Please fill in as much as possible - some may not apply. The more information you provide, the more accurate your personalized X-Ray will be.
A. What are your income goals for the next twelve months? Minimum: $________ WOW goal: $_________
B. Sales Closing Ratio(sc%): ______ % G:______ % U:______ % Final Closing Ratio: ______ % G:______ % U:_____ %
(If you had ten leads, how many transactions would you write?) (If you wrote ten transactions, how many would close?)
(lead = If you receive a name or phone number.)
C. Average Transaction Size: ________ Your Average Commission Per Transaction: $ _________
D. Balancing Life Questions
1. What would be your biggest challenge in increasing your business by 25% to 50%, reaching your "WOW" goal, or maintaining the best balance in every area of your life?
2. On average, how many hours per week do you work currently? (please circle)
Less than 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, more than 65.
3. How many hours would you like to be working to maintain the best balance in every area of your life?
Less than 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, more than 65.
4. Please rate your level of interest in having tools available to you that could help your business grow by 25% to 50% and reduce your work week by 10 to 15 hours by putting systems in place that work when you are not working. (1 to 10, with 10 being greatest) 1 2 3 4 5 6 7 8 9 10
5. When do you plan to implement systems to build a more efficient business?
A. [ ] Immediately, B. [ ] 1-2 months, C. [ ] 3-4 months, D. [ ] 5-6 months, E. [ ] Other ______
6. If you had an extra 10 to 15 hours per week and earned $20,000 to $100,000 more in income, what would you do with that extra time and money?
E. Client/Prospect Information: How many sales consultants are employed by your company?______
1. Number of past clients: _______ Are their addresses and phone numbers current? [ ] Yes, [ ] No
13% x _____ (past clients) = ____(possible deals ) x _______ ($ per transaction) = $________/yrly potential. Lost $_________ over ___ yrs.
2. Number of current clients: _____, prospects: _____, number of new prospects in the last: 3/mo.___, 6/mo.___, 12/mo.___.
3. If you do not know their address and phone number, could you get that information? [ ] Yes, [ ] No
4. Are they on a database? [ ]-Yes, [ ]-No Name of software you are using: ________________________
5. How often do you contact your database? Mail: ______ wk./mo./yr. Phone: _____ wk./mo./yr.
6. Does every prospect get entered into a data base immediately? [ ]-Yes, [ ]-No, [ ]-Most of the time
7. How often do you contact every new prospect by mail and phone? (ones you have received over the last 12 months)
Mail: _______ wk./mo./yr. Phone:_______ wk./mo./yr.
8. Where do most of your leads come from?
9. On average what percentage of the total available business do you receive from your clients? _______%
10. How much money have you invested into your business in the last: 3 mo._______, 6 mo._ ______, 12 mo._______
11. Do you have a written business plan? Yes/No (Reviewed: ___/wk,mo,yr) Interest in developing written plan. ____ (1-10, 10=best)
F. Key Business Information: (The more information you provide, the more accurate the X-Ray.)
Profit/Income Sales/Volume Avg. Hrs./Wk. $ in Business Total Accts --__________ __________
1996 - $__________ $__________ __________ $/%_______ __________ __________ __________
1997 - $__________ $__________ __________ $/%_______ __________ __________ __________
1998 - $__________ $__________ __________ $/%_______ __________ __________ __________
1999 - $__________ $__________ __________ $/%_______ __________ __________ __________
2000 - $__________ $__________ __________ $/%_______ __________ __________ __________
G. Professional Referral Information: (Realtors, financial planners, accountants, attorneys, doctors, insurance agents, builders, etc.)
# of "A" Referral Sources: ____, ___ Aver. # sales/month/"A" referral ______ / (SC%______% = _____
# of "B" Referral Sources: ____, ___ leads/month/referral ____ x $/trans._________ = _____ (available $)
# of "C" Referral Sources: ____, ___ (available $)______ x 15%. = _________/mo to build referral business.
Referral sources on a database? [ ] Yes, [ ] No SC%=Sales closing ratio Money Lost: $_______ over ___ yrs
How much do you earn/ invest each year for each professional referral source and client?
Referral Source: Earn: A:_________, B:_________, C:_________ Invest: A:__________, B:__________, C:___________
Clients: Earn: A:_________, B:_________, C:_________ Invest: A:__________, B:__________, C:___________
Note: Please use reverse side of this page for any additional information about your business that you would like to share.
Copyright © 1999 Life Masteries Institute, Inc. www.lifemasteries.org (888)789-7878 f: saleslet/xraylife.doc
Personal Questions
Name: ___________________________
The review of the Life Stewardship X-Ray is designed to consider all aspects of an individual's life and help the individual implement systems that work even when the individual is not working. By implementing the best systems, you can improve balance in every area of your life.
Marital Status: _______
If married: Years married: _____, Spouse's name: ____________________
Children's Names/Ages: ____________, ____; ____________, ____; ____________, ____;
____________, ____; ____________, ____; ____________, ____.
1. What is the most important thing to you in life? What are your life's priorities?
2. For what do you want to be known? (What would you like to have written about you on your tombstone?)
3. List one personal relationship you would like to improve upon over the next twelve months.
4. List one thing you personally would like to improve upon over the next four months.
5. If you have children, what would you like to do over the next six months to improve your relationship with them?
6. If you are married, list one thing that your spouse would really appreciate on a regular basis that would improve your relationship.
7. What would you like to be doing in five years?
8. In looking at the most important, most valuable relationship you have, list one or two things you did in that relationship that you are not currently doing.
Advanced Personality Testing Form
Within the advanced personality testing, we will "fine tune" the testing and help you identify your primary and secondary personality style. You have 3 items to check in either A
or B, C or D. (ALWAYS CHECK THREE FOR EACH QUESTION!) Based on the degree to which you feel a certain way, check the number of boxes accordingly. The stronger you feel about "A," the more checks you give to it. If you feel that a certain atatement describes you 100%, that statement would have 3 checks.(Example: #1. A-2 checks, B-1 check; you feel you tend to move more slowly and deliberately, but not 100% of the time.)
Assertiveness
1. Do you tend to (A) move more slowly and deliberately, or (B) do you tend to move more rapidly?
A B
2. Do you tend to (A) speak more slowly and softly, or do you (B) tend to speak more quickly, more intensely, and often more loudly?
A B
3. Do you tend to (A) lean backward, even when making a request or stating an opinion or do you (B) tend to sit upright or lean forward, especially to make a request or state an opinion?
A B
4. Do you tend to be (A) tentative and less forceful in expressing opinions, making requests, and giving directions or (B) more emphatic?
A B
5. Do you tend to be (A) less confrontive or (B) more confrontive?
A B
6. Would you tend to (A) let others take initiative, or would you (B) tend to take the initiative yourself?
A B
7. Would you be more likely to (A) request people to do things or (B) tell people what needs to be done?
A B
8. Do you (A) make decisions more slowly or (B) more quickly?
A B
9. Do you tend to be (A) less risk oriented or (B) more risk oriented?
A B
10. Do you exert (A) less pressure for decisions or (B) more pressure for decisions?
A B
11. Do you have (A) less intense and less consistent eye contact, or (B) more intense and more consistent eye contact?
A B
Total A's - Total B's = Final Score-------------------------------------------
Responsiveness
1. Do you tend to (C) limit your use of gestures, or (D) do you tend to gesture more frequently?
C D
2. Do you tend to (C) move more rigidly, or (D) do you tend to move more freely?
C D
3. Do you tend to (C) have less facial expressiveness or (D) do you tend to have more facial expressiveness?
C D
4. Do others see you as being (C) more serious or (D) more playful?
C D
5. Do others see you as being (C) more reserved, or (D) are you seen as more outgoing?
C D
6. Do you prefer to be (C) more formal/structured in your life or (D) less formal/structured?
C D
7. Do you tend to be (C) more controlled in your expression of feeling, or (D) are you more free and less guarded in your expression
C D
8. Do you (C) focus more on facts, or (D) do you focus more on feelings?
C D
9. Do you (C) appear more task oriented, or (D) do you appear more people oriented?
C D
10. Do you (C) tend to be less interested in small talk, anecdotes and jokes, or (D) do you tend to be more interested in these things?
C D
11. Do you (C) make decisions based largely on facts, or (D) do you allow your feelings to have a greater influence on decision making?
C D
12. Do you (C) demonstrate more discipline in your use of time, or (D) do you demonstrate less discipline in your use of time?
C D
13. If you were in a supervisory position, would you (C) supervise in a task oriented manner, or (D) do you supervise in a more personal manner?
C D
Totals: Total C's - Total D's = Final Score-------------------------------------------
Survey
Date: ____/____/______
Session # ___ & ___
Please rate quality of this tool on a scale from 1 to 10 (with 10=Best).
Session Number #____ #____
1) Quality of certified consultant(s) _____ _____
2) Quality of material _____ _____
3) Quality of X-Ray _____ _____
4) Benefit to family relationships _____ _____
5) Benefit to other relationships _____ _____
6) Benefit to career _____ _____
Please complete the following questions:
6) What was the best aspect of this tool?
7) What could be improved?
8) Why would you (or would you not) recommend this tool to others? Please explain.
9) Was the amount of explanation adequate?
10) Please list one or two individuals who might benefit from this type of seminar.
(Family, friends, co-workers, referral sources, etc.)
_________________________ ________________________ (_____)____-_________ _____________
Name Company Phone Personality Type
_________________________ ________________________ (_____)____-_________ _____________
Name Company Phone Personality Type
11) How often do you attend seminars? (please check one)
[ ] Every 3-4 mo. [ ] Every 5-8 mo. [ ] Every 9-12 mo.
12) In which of the following sessions would you like to participate?
A. * ActionVision life planning development E. * Relationship building seminars
B. * Monthly accountability F. * Spiritual Development in Children seminars
C. * Student Life Management System G. * ___________________________
D. * Career enhancement seminars H. * ___________________________
Name:__________________________________ Phone:(______)_________________
ActionVision Certified Consultant's Notes
(To be completed by ActionVision certified consultant.)
Name: ____________________ Company: __________________ Phone:(____)____-______
1. Why has this individual been so successful?
2. What is their WOW goal, and what is the biggest challenge they currently face in achieving that goal?
3. Recommended action to create greatest results with least effort:
4. Recommended strategies to help individual achieve desired hours. Current:___, Goal:___
5. Recommended strategies to help individual have more personal time. Current:___, Goal:___
6. Recommended strategies to assist individual in (specific area of life): ________________________
Would you recommend that this individual go on ActionVision (life development system)? [ ]-Yes, [ ]-No
7. Please rate each key area on focus of actions and effort. ___ (Please rate in order with 1 being the most valuable.)
/__ (On a scale of 1-10 [10=most], how much would he/ she like to be pushed?) Example: 1/10 Personal walk with God
____/___ - Personal walk with God ____/___ - Friends ____/___ Research results
____/___ - Spouse ____/___ - Career ____/___ Time management system
____/___ - Children ____/___ - Church ____/___ Relationship building system
____/___ - Family ____/___ - Community ____/___ - _____________________
____/___ - Loved ones ____/___ Life balancing system ____/___ - _____________________
8. Please recommend information to send individual about other products or services which might assist individual in reaching his/ her WOW experience. (1 being most valuable.)
___ X-Rays ___ ActionVision ___ Mind2 ___ Achievement Plus ___ Life Masteries
___ Daily Masteries ___ MaxSys ___ M.V.P ___ Turnkey Mailing ___ Student Life Management
___ Phone Training ___ Business Mentoring ___ Sales Training ___ Phone Training
9. Names of two other individuals who might benefit from analysis of Business X-Ray.
Name: Company: Pager Number: Phone Number:
______________________ _____________________ (____)____-_____ (____)____-_____
______________________ _____________________ (____)____-_____ (____)____-_____