Free Goals Report

Welcome!

As you complete this 5-minute quiz, you are really coaching yourself.

The standard fee for this service is US$9.95. However, as you have been referred by , this fee has been waived.

Enjoy!

A) RATE YOUR LIFE

1) How would you rate your life out of 10 (10 being you can't imagine it could possibly be any better) in the following areas?

Health & Peace	Money	Career/Own Business
Special Relationship	Family & Friends	Spirituality

2) Given these scores, which 2-3 areas are you willing to improve over the next 6 months to make the biggest difference to your life? (Maximum Three)

Health & Peace	Money	Career/Own Business
Special Relationship	Family & Friends	Other:

3) What three things are you most tolerating or putting up with in your life?

4) What three things are you most loving in your life?

5) If you could have more of ONE thing in your life right now, what would it be?

B) CREATE YOUR GOALS

6) Create 2-3 goals which would make a BIG difference to your life. Choose goals which would put a big smile on your face, and be achievable within 6 months. (Help!)

Goal	Achieve By
a)
b)
c)

7) Imagine 6 months have passed, and you've done it! You have achieved each of these goals. Write down how you would feel having achieved each of these.

Goal	I would feel...
a)
b)
c)

(Hint: If you wouldn't feel wonderful about each of these, then you might like to go back to Step 6) and choose bigger or smarter goals)

C) SHOOTING YOURSELF IN THE FOOT

8) a) Assuming all human beings have some way of holding back or sabotaging their life, which is your favourite method (choose one only)?

Procrastination	Indecisive	Arrogant/ being right
Acting as "Lone Ranger"	Tolerating	Not saying "No"
Controlling life /people	Not saying "Yes"	Following secondary goals (i.e. goals that won't ultimately make me happy)
Not always telling absolute truth		Other:

b) When you notice yourself doing this behaviour (sabotage), what will you now do instead (i.e. what behaviour will you replace it with?)

D) COACHING

9) Goals are much easier to achieve when you have a support structure in place. Which support structure(s) will you put in place this week to make these goals fun and easy? (Max 3)

Motivating display where I can see it often (e.g. put my Free Goals Report up in the bathroom).		Enroll in a (training) course. (e.g. painting course).
Enroll a buddy to go for the same goal(s).		Tell 3-10 friends of my commitment, and how they can support me (e.g. call me every couple of weeks to ask how it's going).
Join a club/hang out with people sharing the same goal(s). (e.g. join a gym & hiking club).		Set up a 1-6 month coaching structure with a good coach.
Other Support Structure:

10) a) If you had your own coach, what would you probably get from the coaching that would be most valuable to you? (3 maximum)

Challenge	Accountability	Focus	Support
Inspiration	Direction	Sounding Board	Ideas/ Strategies
Validation

b) If you ever decided to work with a coach, what would probably be the best time for you to start?

	Within the next 10 days
	Within the next 30 days
	Within the next 3 months
	Within the next 12 months

E) YOUR FREE GOALS REPORT

Free Goals Report
Please send my customised Goals Report including a graph of my 'Wheel of Life' and a copy of 'Top Ten Tips for Achieving Your Goals'

Yes

Free Burst of (Cyber) Coaching*
I would like to receive feedback/coaching on my Goals Report. Please send my referring coach a copy of my Goals Report and contact details.

Yes
(by phone)

Yes
( by email )

Free Reminder Service
As a support structure, I would appreciate a second copy of my Goals Report in 30 days time to give me a friendly nudge along.

Yes
(30 days)

Yes
(30 and 60 days)

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