Questionnaire - Erudiun LLC

First Name *

Email *

Occupation

Hobbies/Projects/Interests

Select Age Group

21-29
30-35
36-40
41+

Marital Status

Rate your current ambition for Growth (1=low 10= highly)

Selected Value: 0

Rate your current ambition for improving Wellbeing

Selected Value: 0

Rate your current ambition for improving Mindfullness.

Selected Value: 0

Rate your current ambition for improving Acceptance.

Selected Value: 0

Rate your current ambition for improving Leadership.

Selected Value: 0

Rate your current ambition for your Career or Business.

Selected Value: 0

Rate your current ambition for Improving Wealth.

Selected Value: 0

Rate your current ambition for Improving overall Productivity.

Selected Value: 0

Rate your current ambition for improving Physical Health.

Selected Value: 0

Rate your current ambition for improving Discipline.

Selected Value: 0

Rate your current ambition for Maximizing Physic.

Selected Value: 0

Rate your current ambition for improving Wisdom.

Selected Value: 0

Rate your current ambition for improving Perception.

Selected Value: 0

Rate your current ambition for improving Relationships.

Selected Value: 0

Rate your current ambition for improving Dating.

Selected Value: 0

Rate your current ambition for improving Attraction.

Selected Value: 0

Rate your current ambition for improving Expression.

Selected Value: 0

Rate your current ambition for Self-Actualization/ Peak Performance.

Selected Value: 0

Rate your current ambition for Ascension.

Selected Value: 0

What are your goals or projects you are working on?

What are the most important things happening in your life right now?

What ways would you like your life to be different 1 year from now? (be specific)

What is getting in the way of these goals?

List three things you procrastinate frequently.

What, if any, are your concerns with this Seminar.

What would you like me to do if you get behind in progress during the Seminar?

How do you like to be supported?

When I say "Growth Based Mindset" what comes to mind?

How much time can you provide to improve and focus on the Seminar. (The Seminar requires at least 2 hours a week to complete)

One Hour a Week
Two Hours a Week
Three Hours a Week
Four Hours a Week

Are you ready to commit 90-days for your own Growth?

Yes
No

Full Metal Intensive

- - Breakthrough Session Preliminary Questionnaire - -