| Please describe your current profession: |
Type of profession:
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| Major product/service: |
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| How long have you been in your profession? |
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| Your greatest challenge of your profession? |
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| Your greatest achievement to date: |
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In what type of home environment were you raised? |
| Challenges faced as a youth? |
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| Please describe what you were like, behaviorally, between the ages of 4 and 14: |
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| What challenges did you face as a youth? |
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| What life lessons did you learn as a youth? |
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| Who positively influenced you as a youth? |
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| Are you doing today what you dreamed of when you were between 4 and 14? |
| No |
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| Yes |
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| If yes, what was your dream? |
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| Did or do you have a mentor for your profession? |
| No |
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| Yes |
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| If yes, how did they specifically help you? |
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| What is most gratifying about what you do in your profession? |
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| What drives you to succeed? |
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| What are the most important lessons learned in your profession? |
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| What lessons have you learned as a successful person in your: |
| Professional life: |
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| Personal life: |
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| How do you define success? |
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| How would you define a successful person? |
| Professionally: |
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| Personally: |
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| In your opinion, what does it take to succeed in organizations today? |
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| How would you define Super-Achievers? |
| In their professions: |
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| In their personal lives: |
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| What advice would you give working professionals today? |
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| In your opinion, what characteristics/attributes, if any, are missing in young professionals today? |
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| Your early life. |
| Describe your family: |
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| Hardships you had to overcome as a youth. |
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| What positive or negative influences from your parents/guardians, helped shaped your talents? |
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| Activities/sports in which you were involved. |
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| Describe your high school years. |
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| Describe your college years. |
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| Do you have any regrets up to this point in your life? |
| No |
|
| Yes |
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| If yes, what would that be? |
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| Please state whether you agree or disagree with the following statements as they relate to starting and running a business: |
| Success doesn't happen overnight |
Agree
Disagree
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| Setbacks will be experienced |
Agree
Disagree
|
| Hope and a dream keep you going |
Agree
Disagree
|
| Naysayers will test you |
Agree
Disagree
|
Emotional strains on personal
relationships will be experienced |
Agree
Disagree
|
Family and friends will be politely
supportive, even though they have their doubts |
Agree
Disagree
|
| Money is sometimes tight |
Agree
Disagree
|
| Professional advice is necessary |
Agree
Disagree
|
Emotional, physical and spiritual pressure
will be felt |
Agree
Disagree
|
Fleeting moments of depression and doubt
maybe experienced |
Agree
Disagree
|
| I am a team player |
Agree
Disagree
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| Name: |
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| Date: |
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