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Self Realisation Form

01 Name
02 Address
03 Residence Owned   Rented
04 If owned , how many year at current residence
05 Mother Tounge
06 Date of Birth
07 Marital Status Married    Unmarried
08 Children
09 Education
a) X Standard   %
b) XII Standard   %
c) Graduation Arts   Science   Commerce   Others
d) Post Graduation
e) Additional qualification
10 Spouse
11 Spouse Education Salaried   House Wife    Self Employee
12 How do you describe your childhood
a) Studious
b) Balance study and fun
c) Study and had more fun
13 Sport
a) which sport you like
b) which sport you think you are good at
c) Did you represent your school, college or state in any sport
14 Extra Curicular activity
a) Any other activity you had enjoyed doing in childhood days
b) Besides Job, what other activity you do consistently
15 Did you got all timely guidance/coaching to make a sucessful Career Yes   No
16 What are area in which you didn’t get good guidance/coaching
17 Did you plan your profession right from your school day? Yes   No
18 Approximately which year did you came to know that your current profession is good for you
19 why did you thought that you should be in these profession
20 In term of overall children development?
a) what is your opionion on our education system?
21 Name of the Company
22 Annual Income
23 Designation
24 Describe your job profile in detail
25 Total work Experience
26 How many year you worked in the current organisation
27 which organisation you spend more year (organisation name& year spend)
28 Since How long you have worked in the current job profile
29 Are you in job that you had always wish to
30 what does job means to you
a) Run your Home OR Pay your Bill
b) Gives meaning to your life
c) Oppurtunity to serve your country
d) Make money for family security and retirement
e) Others
31 How do you describe working style, in your office
a) Task Master
b) Discipline
c) Innovator
d) Don't mind to break rule, if it's benefit organisation
e) Hard Worker
32 personality
a) Introvert
b) Extrovert
33 What are your strength area
34 What are your weak area
a) please rate yourself on % basis in term of money making ability (your potenial V/s actual)
b) For egs your potential is to earn 50 lac Rupees whereas in actual earning are
35 Do you make friends Immediately   I take my own time  
36 Who is your guru ? And why?
37 How many close friend you have
38 Do you belive in networking Yes   No  
39 What does people like in you
40 what does people do not like in you
41 what attributes you would like the most ,that people should associate with you Thinker/innovatore   Funny   Cool   Hard working   Helpful   Others  
42 Rate your self on the following parameter So So Good Better Excellent
a) Fashion Sense
b) Colour Sense
c) Creative Sense
d) Romantic Sense
e) Funny Sense
f) Movie Sense
43 Given a time and chance, which hobby would you like to develop in future?
44 Describe the future of your industry and its implication on your job?
45 Career Goal
a) Have you reach your career goal,that you had set for yourself   %
46 Would you think , it will better to supplement your income with some part time income Yes   No  
47 Have you tried any busniess in the past Yes   No  
48 What are the hurdle in pursuing in such partime income
49 in term of % how do you describe your self as
a) Family Person
b) Family & Friends
c) Friends
50 do you things with more guidance, you would have grown in your jobs Yes   No  
51 In future, you would require assistant in which area Yes   No  
52 About your work, are you a Multitasker   One job at a time  
53 Tell us anything you did in your jobs that felt like an job satisfication
54 Do you think you are in control of your life Yes   No  
55 Do you take regular family holiday Abroad   Domestic  
56 Do you take long holiday Yes   No  
57 if not what are problem Money   Not very outdoor person  
Staying away from office for long time   May not good for growth  
58 In regards to your spending, how do you rate yourself Conservative   Balance   Spend thrift  
a) In case you are spend thrift, do you want gudiance to control your spends
59 What are the attribute you consider while spending? Durability   Style  
Very unique style- different then other   Expensive price only  
Durability and style   Durability and very unique style  
60 How do you rate yourself/family in term economic classification
Middle Class   Upper Middle Class  
High class   Celebrity class  
61 which economic classification you would like to associate with Middle Class   Upper Middle Class  
High class   Celebrity class  
62 Share your view point on the line mentioned below
a) Succesful career, The money you make at the end of your career
b) Defination of retirement, I am at peace, where I have taken care of my retirement expense and have fulfilled all family responsibility
63 In future do you have plan to start your own business Yes   No  
a) Please let us know , which sector for egs 1) Hotel or any other
64 Visualie your retirement plan ,based on below mentioned parameter
a) Retirement corpus that you wish to build Up to 20 lac   20 to 40 lac   40 to 60 lac   60 to 1 Cr   
1 to 1.5 Cr   1.5 Cr to 2 Cr    1 to 1.5 Cr   1.5 Cr to 2 Cr   
b) pay for son, daughter marriage
c) Vacation Abroad
d) What is your vision about yourself
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