Name: (Code and Intake date) __ __ __ _ ____-____-____                     Date:   _______________

 

NOTE: If you circle more than one YES, please put a double circle over the dominant one.

REMEMBER ALSO: These five scenarios have no wrong answers!

 

1.         Late one day, along with other cruise passengers, you get stranded on what seems to be uninhabited land. Would you be willing to help (without questioning the authority of the task’s temporary leader), start to organize (be responsible for a task and willing to be held accountable for its success), or help coordinate (in whatever capacity needed at that time)?

Be willing to do?           anything I know how to do | anything I was asked to do

Start to organize?          yes | no | maybe

Help coordinate?          yes | no | maybe

 

2.         It’s been a few weeks now since you won the lottery. You’re getting closer to deciding what to do with the bulk of the money (with what’s left after paying the bills). Would you give money to a special cause (without maintaining control), start a business (anything from a fruit stand to a franchise operation), or simply invest the money and carry on as usual (maybe because you’re already doing something you enjoy?) Again, circle one on each line and then pick a favorite.

Donate to a Cause:       yes | no | maybe

Start a business:            yes | no | maybe

Carry on as usual          yes | no | maybe

 

3.         This talk keeps coming up about vacations. In a debate, would you argue on the side of “periodically getting away from it al,” on “if you enjoyed your job, you wouldn’t need a vacation,” or argue with those who “turn vacations into legitimate business trips”?

Periodically, I need to get away from it all          yes | no | maybe

It’s the best time to conduct business                 yes | no | maybe

I enjoy my job, so I seldom need one                yes | no | maybe

 

4.         A genie grants you one wish. Would your wish be practical (communal in nature, family- or group-driven)? grandiose (personal in nature, meaning, ego-driven)? or idealistic (meaning, philosophical, national/global in nature, diversity-driven)?

Practical:                      yes | no | maybe

Grandiose:                    yes | no | maybe

Idealistic:                      yes | no | maybe

 

5.         Do you learn best by studying (reading instructions before assembling items bought as kits)? by doing (e.g., do you try to assemble kits without first reading instructions)? or by sharing (like helping a novice or child discover the joy of assembling their own toys/tools/furniture)?

Through studying:          always | sometimes | seldom

I learn by doing:            always | sometimes | seldom

While sharing:               always | sometimes | seldom