Women 2000 Survey?

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Please HELP me! I am writing a book entitled: Woman 2000 and I need 2000

women to fill out this survey ASAP * The survey is a quick read in 5 Parts

Thank you, and Have FUN !
 
 

Part 1: Who are YOU?

Choose 2 SHAPES which best describe You as a PERSON.

( Click on your first TWO choices that you feel represents your personality:)
 

Square	Triangle	Rectangle	Circle	Squiggle

NOTE: You will find a brief description of the meaning of each shape at the end

of this survey. This is a system of personality analysis called

Psycho-Geometric-tm You can learn more about it by visiting my Website.
 
 

If you had a personal Bumper Sticker made for your car, what would it say?

(Fill in the blank below. )
 
 

"I 'd rather be ....(Example: " I'd rather be bowling. " )

How do you position yourself Politically? (Click One)

liberal conservative moderate

1D Which Famous woman would you most WANT TO BE? (Choose One)

 

Madeline Albright	Hillary Clinton
Kim Basinger	Katie Couric
Oprah Winfrey	Madonna
Estee Lauder	Mrs. Bill Gates
Celine Dion	Condoleezza Rice

---

1E How would you WANT friends to describe you? (Click One)

 

loyal	sweet
smart	successful
fun	gorgeous

1F What do you WANT MOST IN LIFE? (Choose One)

 

thin body	financial security
loving mate	fame
happy children	inner peace
close women friends

Part 2: What do you WANT for your NATION? (Click top 2)

True Leaders	More Women in Power
Strong "World Peacekeeper"	Strong Human Rights Policies
Protect the Environment	Separate Church from State (abortion,etc.)
Less Big Government	Reduce Role of Media
Help for Poor & Underprivileged	Help for Middle-Class

Part 3: What do you WANT in a JOB?

3A: General Working Environment (Click 2 most Important)

Important Work	Genuine Teamwork
Recognition	Capable Co-workers
Monetary Rewards	Capable Leaders
Good Healthcare Plan	More Women Leaders
Good Retirement Plan	Reduced hours/Flextime
Respect from Superiors	Work at Home
Training Opportunities	Equal Treatment for ALL

3B: Capable Leaders (Click 2 needed Leadership Actions )

 

Replace incompetent managers

Set higher performance standards

Pay workers based on performance

Assure opportunites for ALL

Share profits with all workers

Reduce executive pay

Create true teamwork

Give workers authority

Tell people the truth

3C Your immediate Boss (Click top 2 things you want your Boss to do NOW....)

Communicate more	Stop showing favoritism
Learn to listen	Learn what I do
Take smart pills	Tell the truth
Ditch the EGO	Leave me alone to do my job
Show me respect	Get some management training
Set higher standards	Recognize effort, not problems
Take Charge!

3D: Job Satisfaction (Click 1 answer only)

"My Job is ........"

Boring	Ideal
Routine	Overwhelming
Interesting

3E Training Needs (Click top 2 types of training you WANT NOW )

Assertiveness	Project Management
Management Skills	Writing Skills
Financial Planning Skills	Memory Development
Communication & Listening	Sales Skills
Teamwork Skills	Time Management Skills
Stress Management
Computer/Technical Skills

Part 4: What do you WANT? in your PERSONAL LIFE

4A: What do You WANT NOW? (Click top 2 choices)

 

to simplify my life	freedom to pursue dreams
more private time	more money
time for family	loving relationship
less work responsibility	thinner body
more sharing home duties	more self-confidence
close friendships

 

time with friends	domestic travel
time with family	foreign travel
church activities	pursuing hobbies
work projects at home	enjoying computer
physical exercise	shopping
meditation/quiet time	reading
massage/beauty treatments	going to college
watching favorite TV	playing sports/games
nightlife fun/carousing

4C: What do you WANT in BED? (Click One)

 

true love

tenderness

variety

talk

sleep!

PART 5

NOTE: You must fill out Part 6 to participate in the survey!

Your answers will he kept totally confidential.

Part 5: Demographic Data

5A. AGE:

Under 18

18-30

31-45

46-65

Over 65

 

6B. Family Status (Click ALL Correct Answers)

Married

Divorced/Widowed

Never married

Children under 18

Children over 18

 

Ethnic Group

Caucasian

Black

Hispanic

Asian

Native American

5D. LOCATION:
 
 

State

Country

5E. INCOME LEVEL:

Under $25, 000

$25, 000 - $36, 000

$37,000 - $50 ,000

$51, 000 - $75, 000

$75,000 - $100, 000

Over $100,000

5F JOB CATEGORY
 

unemployed	finance
manager	education
executive	healthcare
secretarial	technical
doctor/lawyer	nonprofit.
company owner	government
sales person	Other

5G Education Level

 

drop-out

high school degree

some college

bachelors degree

advanced degree

 MESSAGE TO SURVEY PARTICIPANT:

Now the FUN PART!! .... YOUR DEFINING MOMENT

Please write a paragraph description of a situation from your life that became the "Defining Moment" in who you are.

Message to Survey Participant:

YESNO Are you willing to have a Personal Interview with the author, Dr. Susan Dellinger?
 
 

IF YES . . 6 . . Your E-Mail Address:
 
 

Your Phone Number:
 
 

2 . As promised in Part 1: Here is a basic personality interpretation of your SHAPES:
 
 

Square People: organized, logical, conservative, loyal, boring
 
 

Triangle People: strong, decisive, political, egotistic leader
 
 

Rectangle People: confused, changing, growing, unpredictable
 
 

Circle People: harmonizing, talkative, self-critical, warm
 
 

Squiggle People: creative, witty, impulsive, weird, sexy
 
 

NOTE: For more info on Dr. Dellinger's Psycho-Geometrics Systems-tm please go to her website at http://www.drsusan.net

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