This quick-quiz is designed to help us help you to reach your goal. You are under no obligation to continue coaching sessions after your first FREE session. Your details will not be given to any outside parties or will be used for any other purpose than initiating your FREE, no-risk coaching session.

Have fun completing the quiz. I look forward to receiving it and chatting with you soon.

As a child, I wanted to grow up to be a: (e.g. Doctor, Policeman, Nurse…)
As an adult, I my dream/goal is:
The first thing I’d like to change/improve is:
The second thing I’d like to change/improve is:
I have created a plan that ensures my success. It is: (Check one) All in my head Written on post-it notes Written in my journal I have concepts of a plan I don’t have a plan
I believe I can reach my goal if… (Check one or more)
I have a guiding hand
The time was right
My circumstances allowed for it
I can identify and overcome some obstacles
The thing I like most about myself is:
Imagine. Tomorrow you’re scheduled to deliver an important presentation to a key client. The venue is outside and not undercover. After hearing a storm is forecast for tomorrow you:
Ring to reschedule your presentation for another day Select another venue and alert your clients Ask your friend for advice on what to do Panic! You’ve missed the deal of a lifetime
Which best describes you?
Excellent at delegation An ideas person Hands-on worker
How much knowledge do you have about your goal?
None Little Moderate High Level
While trying to achieve your goal, your attention is focused on: (Check one or more)
The end goal
The present situation
What others are saying
To achieve the ultimate means to: (Check one) Win at all costs Be true to yourself Get others to do the dirty work Gain trade secrets behind closed doors
When was the last time you paid somebody a compliment? Today Yesterday Last Week I can't remember
Name
E-Mail
Address 1
Address 2
City
Province or	Select Province or TerritoryAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon
State	Select StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareColumbia (District of)FloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
Zip/Postal Code
Country	Select CountryAfghanistanAlbaniaAlgeriaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia-HerzegovinaBotswanaBrazilBritish Virgin IslandsBrunei DarussalamBulgariaBurkina FasoBurmaBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas Island (Australia)Cocos Island (Australia)ColombiaComorosCongo (Brazzaville),Republic of theCongo, Democratic Republic of theCook Islands (New Zealand)Costa RicaCote d'Ivoire (Ivory Coast)CroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Indonesia)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaGabonGambiaGeorgia, Republic ofGermanyGhanaGibraltarGreat Britain and Northern IrelandGreeceGreenlandGrenadaGuadeloupeGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia, Republic ofMadagascarMalawiMalaysiaMaldivesMaliMaltaMartiniqueMauritaniaMauritiusMayotte (France)MexicoMoldovaMonaco (France)MongoliaMontserratMoroccoMozambiqueNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNorth Korea (Korea, Democratic People's Republic of)NorwayOmanPakistanPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandPolandPortugalQatarReunionRomaniaRussiaRwandaSaint HelenaSaint Kitts (St. Christopher and Nevis)Saint LuciaSaint Pierre and MiquelonSaint Vincent and the GrenadinesSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia-MontenegroSeychellesSierra LeoneSingaporeSlovak RepublicSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia (Falkland Islands)South Korea (Korea, Republic of)SpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzaniaThailandTogoTokelau (Union) Group (Western Samoa)TongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis and Futuna IslandsWestern SamoaYemenZambiaZimbabwe
Telephone
Preferred contact:	Telephone E-Mail
Questions/Comments