SURVEY FORM: EMOTIONAL-WEALTH^TM FOR INVESTING SUCCESS

Upon submission of this form, you will get a report online, and

1. you will recieve a profile of your emotional values that impact your financial sucess.
2. how your emotions reward and punish you in normal conditions and during stress.
3. how to cleverly avoid danger and improve your emotional values.
4. an example of how one person use Emotional-Wealth^TM to become successful.

See Example Report

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First Name

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There are 16 questions. Each question must have two answers.
One for 'Most' and another for 'Least'.
'Most' describes you best, and 'Least' describes you least.
We need you to answer all of them

1. When making investments	Most	Least
I am very confident of making the right decision.
I am usually confident of making the right decision.
I am sometime confident of making the right decision.
I often lack confidence in making the right decision.

2. When presented with a new investment angle	Most	Least
I am always game for new ideas.
I am game only for ideas that come from trusted sources.
I am skeptical of unqualified opinions.
It takes a lot to convince me that this is something new.

3. I am disciplined to the point where	Most	Least
I am very good at anticipating problems.
I am able to anticipate about 50% to 75% of impending problems.
I am able to anticipate about 25% to 50% of impending problems.
I still face lots of unexpected problems every week.

4. Do you keep a priority list?	Most	Least
Yes I stick to a priority list.
I sometime make exceptions to my priority list.
I can get by without a priority list.
I don't believe in a priority list.

5. How approachable are you?	Most	Least
People are often happy to run their ideas by me first.
People like to test their ideas with me.
People do not often come to me with their ideas.
People rarely come to me with their ideas.

6. In dealing with uncertainty, you	Most	Least
Take calculated risks.
Risk small stakes.
Prefer to play it safe.
Avoid taking any risk.

7. As you look around the environment, you	Most	Least
Always notice new opportunities
Notice the occasional opportunity
Seldom notice new opportunities
Are oblivious to opportunities

8. How good are you at timing your investment decisions?	Most	Least
Good timing: Get it right most of the time.
Average timing: Get is right about half the time.
Inconsistent timing: Erratic, with winning and loosing streaks.
Bad timing: Usually get it wrong.

9. In making investment decisions you are	Most	Least
Self directed.
Undirected.
Emotionally directed.
Follow the crowd.

10. How aware are you of your surroundings?	Most	Least
Well informed.
Somewhat informed.
No need to be informed.
Nothing surprises me.

11. Regarding investments and returns, you are	Most	Least
Happy only with high returns.
Accept high risk, high returns.
Accept small risk, low returns.
Satisfied with low returns.

12. In investing, you consider yourself a	Most	Least
Top performer.
Good performer.
Average performer.
Below average performer.

13. Which of the following best describe your feelings about your investments?	Most	Least
Happy and satisfied.
Somewhat satisfied.
Somewhat unhappy.
Very unhappy.

14. In investing, you consider yourself a	Most	Least
High achiever.
Above average achiever.
Satisfactory achiever.
Below average achiever.

15. What sort of learner do you describe yourself?	Most	Least
I am an active-learner
I am an interest-directed learner
I am a need driven-learner
I feel that there is usually nothing interesting to learn

16. You consider yourself financially	Most	Least
Very successful.
Adequately successful.
Could be more successful.
Very unsuccessful.

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