Next-Level Life Pre-work Next-Level Life Pre-work QuestionnaireYour Name* Your Email* Gender* Male Female Age* 18-24 25-34 35-44 45-54 55-64 65-74 75 and older Will your spouse attend? If so, what's his or her name and T-shirt size?:* Do you have any dietary restrictions?* Life Status:Relationship Status* Married Single How many children do you have?* Family Status:*Describe what's positive and negative with your family today.What best describes your current occupation?* Entrepreneur CEO/President Team Member Other Career Status:*Describe what's positive and negative with your career today.God Status:*Describe what's positive and negative with your relationship with God today.Social Status:*Describe what's positive and negative socially (community/friends) today.Personal Status:*Describe what's positive and negative personally (i.e. personal growth, learning, emotional health, etc.) today.What are internal problems you're struggling with?*(Ex. Stress, discontent)What are external problems you're struggling with?*(Ex. Conflict with family)What are philosophical questions you're struggling with?*(Ex. Will my spouse and I ever be on the same page? Will life always be this hard?)If you could wave a magic wand, what do you desire your life to look like?*On the other side of your Next-Level Life, what would you like to see improved in your life?*If you didn't attend Next-Level Life, how could you see life getting worse?*Approximate average household income* 0 - $24,999 $25k - $49,999 $50k - $74,999 $75k - $99,999 $100k - $149,999 $150k - $199,999 $200k - $499,999 $500k and up Financial Status:*Describe what's positive and negative with your finances today.Physical Status:*Describe what's positive and negative with you physically (health/fitness level) today.Top Influencers:List the 10 people (by name and excluding your children under age of 18) you spend the most time with.*Surface Level Responses:Check all surface level responses that you are struggling with. Getting worth from people People pleaser Need for approval Fear of failure Not good enough Unhealthy boundaries Defensiveness Need to be right Controlling Feeling out of control Unworthy Victim mentality Selfishness Self sabotage Focus on feelings vs facts Shame Guilt Anger Protecting with walls Survival mode Isolation Jealousy Negative self-talk Making assumptions Getting worth from accomplishments Comparing myself to others Worry Perfectionism Unlovable Insecurity Judgmental Denial Submission Responsible for others well-being Anxiety Fear Pride Codependent Blame Force-of-habit thinking Please tell us your shirt size? Small Medium Large X-Large XXL By clicking Submit, we will send you our weekly email with news, podcasts, and more information. If you no longer wish to hear from us, you can unsubscribe at any time from the footer of any email. You can also view our Privacy Policy for more information on how we protect your data.
