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Preliminary Information

Full Name *

Email *

Age

We use your age to help to generate the numbers... we know that sharing your age is something YOU choose to do!

What age you intend to live to?

We know you can't predict the future, (and it could be considered morbid) but what age do you think you will live to see?

Gender

Male

Female

Time Spent Assessment

This section is going to assess how you spend your time. If you need to, guess the best numbers that you can. You can tweak the numbers later to play with the report. Most of the answers will be in HOURS per week or HOURS per day.

How many hours a week do you spend working? *

How many hours a day do you spend Eating?

How many hours a day do you spend Sleeping?

How many hours a day do you spend Driving?

How many hours a day do you spend Dressing / Bathing / Preparing Yourself?

Self Betterment

This part of the questionnaire is dedicated to assessing how much time you spend improving you.

How many hours do you spend per day focusing on Spiritual things? *

How many hours do you spend per day reading Non-Fiction Material?

How many hours do you spend per week exercising?

How many hours do you spend per week focusing on your own self betterment?

Maybe listening to Podcasts, asking advice, etc.

How many hours per month do you spend alone self reflecting?

Focusing on Others

This part of the test is focused on how much time you spend serving or focusing on others.

How much quality time (hours per week) do you spend your significant other?

How many hours do you spend per week focusing on Children?

(yours or other people's)

How many hours do you spend per week focusing on your friendships?

How many new people do you meet each week?

How many hours per month do you serve someone else with no gain? *

Extra Curricular

This section is focused on those things that you do that are not part of your routine.

How many days per year do you vacation? *

How many hours per week do you do what you want?

How many hours per week do you spend on hobbies doing what you love to do?

(sports, reading, gardening, etc.)

How many hours per week do you spend relaxing?

How many hours a day do you watch TV?

How many hours a day do you surf the web?

(Facebook, Amazon, etc.)

The Chores

We all have things that we have to do, that we would avoid if we could.

How many hours per day do you spend doing inside house chores? *

How many hours per week do you spend doing work outside?

How many hours a week do you cook?

How many hours a week do you grocery shop?