A. My Interests: Evaluate the following possible interests and indicate how important they are to you with a number from 0 to 10. Zero means that it does not interest you at all. And ten means that it is extremely important to you.  Place your evaluation on the left of the number and any clarifications on the right.
__1. Music ? what type?  ________________________________________________
__2. Dancing what type? ________________________________________________
__3. Painting ? sketching what type?_________________________________________
__4. Nature ? where ______________________________________
__5. The sea or ocean _____________________________
__6. Waling in Nature _______________________
__7. Hiking in the mountains ______________________
__8. Athletics, sports ? participating or watching? ? what type ___________________ ___
__9. To have and bring up children. ? How many?  ___________
__ 10. Reading ? what subjects?  ______________________________
__11. To help others ? selfless service ? voluntary work ? what type? _________________
__ 12. Traveling ? how ? where?  ____________________________________
__13. Spiritual exercises disciplines ? which?  ____________________
__14. Physical exercises ? type?  ________________________
__15. Going out and enjoying myself ? where?  ____________
__16. Recreation ? what type? ____________
__17  Going to the movies ? type?  _______________________
__18. T express myself in the following ways.  _______________________________
__19. To stay home and relax and rejuvenate myself ? how?  _______________________
__20. To follow lectures and seminars ? what type ? subjects?  ______________________
__21. Watching TV ? which programs? ____________________________________
__22. The books that I have enjoyed most or have touched me the most are: ______________
___________________________________________________________________
______________________________________________________________________________________________________________________________________
__23. I like to discuss the following subjects:  ________________________________________________ ________________________________________________________________________________
My other interests and hobbies are: 
__24. _____________________________________________________________
__25. ______________________________________________________________
__26. ______________________________________________________________
__27. _____________________________________________________________
__28. _____________________________________________________________
__29. _____________________________________________________________
__30. _____________________________________________________________

B. Words that Describe Me
Evaluate how much the following words describe you with a number from 0 to 10. Zero means that it does not describe you at all. And ten means that it describes you very well.  Place your evaluation on the left of the number and any clarifications on the right.
Evaluate yourself based on your past while having in mind the changes that have taken place within you. 

__1.     Affectionate
__2.    Capable
__3.    Friendly
__4.    Intelligent
__5.    Honest
__6.    Respected
__7.    Physically strong
__8.    Hard working
__9.    Religious
__10.    Spiritual
__11.    Creative
__12.    Educated ________________________________________
__13.    Ambitious
__14.    Peaceful
__15.    Having faith in God
__16.    Loving towards animals and plants. 
__17.    I love nature 
__18.    I love the sea 
__19.    I love the mountains 
__20.    Self-confident. 
__21.    Likeable 
__22.    Sensitive towards others feelings and needs. 
__23.    Attractive 
__24.    Free to  express myself as I feel. 
__25.    Humble 
__26.    Wealthy ? well off 
__27.    Disciplined 
__28.    Self-sufficient 
__29.    Flexible 
__30.    Democratic 
__31.    Courageous 
__32.    I can accept and positively use criticism 
__33.    I am interested in spiritual evolution. 
__34.    I want to help others. 
__35.    Athletic
__36.    Resourceful
__37.    Understanding
Other words and phrases that describe you.
__38.     _________________________________________________________
__39.    _________________________________________________________
__40.    _________________________________________________________
__41.    _________________________________________________________
__42.    _________________________________________________________
__43.    _________________________________________________________
__44.    _________________________________________________________
__45.    _________________________________________________________
__46.    _________________________________________________________
__47.    _________________________________________________________
__48.    _________________________________________________________
__49.    _________________________________________________________
__50.    _________________________________________________________

C. I have the following positive qualities.
(Do not be bashful. You are free to repeat and emphasize qualities mentioned above.)
1.    ________________________________________________________________
2.    ________________________________________________________________
3.    ________________________________________________________________
4.    ________________________________________________________________
5.    ________________________________________________________________
6.    ________________________________________________________________
7.    ________________________________________________________________
8.    ________________________________________________________________
9.    ________________________________________________________________
10.    ________________________________________________________________
11.    ________________________________________________________________
12.    ________________________________________________________________
D. I have the following weaknesses and faults: 
1.    ________________________________________________________________
2.    ________________________________________________________________
3.    ________________________________________________________________
4.    ________________________________________________________________
5.    ________________________________________________________________
6.    ________________________________________________________________
7.    ________________________________________________________________
E. I can understand, forgive, accept and love others ? except when they do the following: 
1.    ________________________________________________________________
2.    ________________________________________________________________
3.    ________________________________________________________________
4.    ________________________________________________________________
5.    ________________________________________________________________
6.    ________________________________________________________________
7.    ________________________________________________________________
F. My goals in Life:
(Let us know here what your life goals are. What would you like to have accomplished, manifested before you leave your physical body. Let us know about each. Think of goals concerning:
1.  Your physical body, appearance, health, strength etc. _____________________________________
2. Your emotions__________________________________________________________________
3. Family__________________________________________________________________
4. Profession / work________________________________________________________________
5. Economics __________________________________________________________________
6. Social __________________________________________________________________
7. Relationships __________________________________________________________________
8. Projects __________________________________________________________________
9. Hobbies __________________________________________________________________
10. Spiritual life __________________________________________________________________
11. Service to Society _________________________________________________________________
Other goals
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

G. My Life Philosophy (Please let us know how you perceive life and its meaning.)
For example write a few words on the following subjects. Take as much space as you need.
For me:
1. In general, I believe that the purpose of life is ?..
2. I believe that my specific life purpose is ?..
3. Relationships are important because?..
4. For me God is ?..
5. I perceive my relationship to humanity in this way?..
6. I perceive death as ?..
More about my life philosophy??..
H. My spiritual life:
(Share with us here the methods or ways in which you care for your body, mind and soul and attend to your inner peace and spiritual growth. You can also share with us steps that you plan in employ for even greater health, peace self-knowledge and whatever other goals of self-improvement or spiritual growth.) Use as much space as you need.
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
I. More about me that I would like you to know. 

From our Conscious Love Relationships Program at: http://www.HolisticHarmony.com/relationships/index.asp