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NAME: _____________________________
AGE: _______________________________
EMAIL: _____________________________
PHONE: ____________________________
Please rate the following questions by importance
 using the following scale for each of the
questions below: 1 No Importance
2 Little Importance
3 Normal
4 Some Importance
5 High Importance
 
1. Spending time with family and friends. 1 2 3 4 5
2. Being able to pay the bills on time, every time.
   1 2 3 4 5
3. Quality education and health cover for yourself/
   family. 1 2 3 4 5
4. Material objects. i.e.. Cars, houses. 1 2 3 4 5
5. A large income. 1 2 3 4 5
6. Retirement. 1 2 3 4 5
7. Travel. 1 2 3 4 5
8. Giving to charity. 1 2 3 4 5
9. Learning new skills and meeting new people.
   1 2 3 4 5
10. Leaving your current job. 1 2 3 4 5

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