Student X-Ray

To accomplish our dreams and goals, we need to know what they are, how we are going to accomplish them, and how we are progressing toward them. We also need to seek help from others to achieve our full potential. This section is designed to help the president be his/her best.

If we want to accomplish our dreams and goals, we need to do the following four things:

The first tool is the Student Life X-Ray. This tool is designed to assist the president and his/her board in identifying where his/her strengths and weaknesses are and what he/she values in each of life's areas.

The five pages after the X-Ray assist the president in walking through the process of what his/her dreams and goals are and what ingredients are needed for success.

A number of tools have been included in the system that will help the president more fully understand his/her natural strengths and weaknesses. Please talk to your certified consultant or call the Life Masteries Institute for more learning resources.

Personality Insight: This tool is extremely powerful for both the president and the board members as it improves the team's understanding of how to work together, how to interact with one another, strengths, weaknesses, what causes pain and pleasure, and how to function as a team. It will also provide insight into what type of personality this individual is attracted to and how different personalities will interact in a relationship. It will also assist the president in understanding how to motivate him-/herself and those around him/her, what causes conflict and why, and how to be the best possible leader for the team.

Name:

E-mail:

Phone: ()

Date: // Age:

For period from // to //

like to make an $85 contribution to Life Masteries Institute for my personal Life X-Ray.

Credit Card #

Signature:

Expiration Date: /

Please rate yourself on the following questions on a scale of 1 to 10. On the first line, ___, please rate where you think you are currently (10 = you are doing everything that you think should be done). In the box [___], please rate how important this area is to you (10 = most important).

A. Dreams and Goals

[] 1. Knowledge of what your dreams and goals are

[] 2. Your drive to reach them

[] 3. Your energy and excitement to achieve your dreams and goals

[] 4. Ability to stick to things even when things get tough or don’t work out

[] 5. Ability to pursue them even when you “fail” to hit some of your goals

[] 6. Ability to include other people in helping you to achieve them

[] 7. Ability not to get distracted by new, fun, and exciting things and to follow through on what I set out to do

[] 8. Stubbornness and openness to others’ input

[] Totals

B. Relationships

[] 1. Ability to know what it takes to develop relationships

[] 2. Not giving up on relationships when things get tough

[] 3. Creating and maintaining relationships that are fun, exciting, and enjoyable for everyone

[] 4. Having a few really deep relationships

[] 5. Not being too picky in relationships

[] 6. Not being pushy or controlling

[] 7. Ability to be serious within a relationship

[] 8. Ability to share feelings and not hold in bitterness

[] Totals

C. Educational

[] 1. Doing well in school

[] 2. Being confident in school

[] 3. Having fun at school

[] 4. Friendships at school

[] 5. Not focusing too much on details in education

[] 6. Being sensitive to others’ feelings.

[] 7. Getting serious about education when appropriate

[] 8. Handling conflict appropriately

[] Totals

D. Personal Development

[] 1. Your skills in doing things the “right” way

[] 2. Your ability to bounce back when you’re disappointed

[] 3. Your ability to see the humor in situations when you make mistakes

[] 4. Ability to care deeply about others’ needs, feelings, and thoughts

[] 5. Not being too hard on yourself when you don’t do things the “right” way

[] 6. Ability to be sensitive to people’s feelings and thoughts when they don’t agree with yours

[] 7. Ability to follow through on something even when it’s not fun or you don’t want to

[] 8. Ability to deal with conflict properly and not become bitter

[] Totals

E. Spiritual – Optional, check with parents.

[] 1. Knowledge about spiritual things

[] 2. Follow-through on necessary spiritual actions

[] 3. Having an exciting spiritual life

[] 4. Feeling close to God

[] 5. Believing that God loves you very much in-spite of your weaknesses

[] 6. Believing that God wants a close personal relationship specifically with you

[] 7. Taking your spiritual life seriously and working at it daily with consistency and discipline

[] 8. Believing that my personal relationship with God makes a difference in my daily life

[] Totals

General Life Questions

Life in general:

A. /[] - Stress

B. /[] - Life Balance

C. /[] - Family

D./[] - Personal time

For School or job:

E. /[] - Personal discipline

F. /[] - Consistency

G. /[] - Passion for success

H. /[] - Willingness to invest $ into yourself

Life in general:

I. /[] - Push yourself,

J. /[] - Achieving your full potential

K. /[] – Spiritual. Would you like input? Y/N

L: /[] - Motivation

M. Parents:

/[] –Relationship w/Dad

/[] – Relationship w/ Mom

/[] – Your opinion of Dad’s rating of the relationship

/[] - Your opinion of Mom’s rating of the relationship

N. /[] - Relationship with brothers/sisters

O. /[] - Self-confidence

P. /[] - Self-esteem

Q. /[] - Self-worth

As it relates to achieving your full potential:

J1. /[] - Passion

J2. /[] - Proper knowledge

J3. /[] - Actions

J4. /[] - Self discipline

R. /[] - Time management

S. /[] - Organization

T. /[] - Focus

U. /[] - Follow-through

V. /[] – Not procrastinating

W. /[] - Handle details well

X. /[] - Control situations well

Y: /[] - Excite others

Z. /[] - Sensitive to feelings of others

aa. /[] - Setting goals

ab. /[] - Proper prioritization

ac. /[] - Control emotions

ad. /[] - Control over feelings

ae. /[] - Positive attitude

af. /[] - Proper confrontation

ag. /[] - Positive thinking

ah./[] - Negative guilt

ai. /[] - Patience

aj. /[] - Financial plan

ak. /[] - Money management

al. /[] - Enjoy current position (if applicable)

am. /[] - Company support (if applicable)

Please rate in order from 1 to 4 (with 1 being first) which of the following would cause you the most frustration (to the left of the capital letter) & which shape you like the most (to the left of the small letter).

A. Dreams and Goals

1. List two dreams and goals for the next three months.

2. What are your friends' personal dreams and goals?

3. What do you need to do daily to get closer to your personal dreams and goals?

4. List five of the most important dreams and goals you want to accomplish over the next twelve months.

5. What are two disciplines that you need to learn and do every day to accomplish your twelve-month goals?

6. Who in your life could most effectively help you reach your dreams and goals?

7. How will achieving your dreams and goals affect your loved ones?

8. What are two or three of your long-term dreams (anywhere from 5 to 20 years down the line)?

9. What three things do you need to do over the next review period to get closer to your dreams?

10. What will you see, hear, feel, or experience when you have accomplished your big dreams and goals?

11. What good choices do you need to make to accomplish your big dreams and goals?

12. List two bad choices you could make that could destroy or hurt your dreams.

B. Relationships

1. What relationships do you value the most and why?

2. What do you think could be done to make your relationship with your dad a "10?"

3. What do you think could be done to make your relationship with your mom a "10?"

4. What do you think could be done to make your relationship with your brother(s) and/or sister(s) a "10?"

5. What do you think could be done to make your relationship with your teacher(s) a "10?"

6. What do you think could be done to make your relationship with your friends a "10?"

7. What do you think could be done to make your relationship with a boyfriend or girlfriend a "10" (if applicable)?

8. What do you think you could do to be a better friend to others?

9. What are some important things that you look for and value in your friends?

10. List the three people you admire most.

11. How will the influence of your friends make a difference in your life goals and dreams?

12. If you could change one thing about your family, what would it be?

13. What do you like most about your family?

C. Education

1. What is the most significant thing you have accomplished during this evaluation period?

2. Who that is now assisting you with your education provides you with the most encouragement ?

3. What do you like most about school?

4. What do you like least about school?

5. What could you do to get more out of school and have more fun doing it?

6. What could your parent(s) do to assist you with any area of your schooling?

7. What could your teacher(s) do to help you reach your full potential in school?

8. What three good choices will you make over the next review period to improve your learning experience?

9. List several bad choices you have made during this evaluation period that have hurt your learning experience.

10. If you continue to make those bad choices, what impact will those bad choices have on your long-term learning? Life? Happiness? Family and friends?

D. Personal Development

1. What is the most significant thing you have accomplished during this evaluation period?

2. What is your greatest strength?

3. What is your greatest area of weakness?

4. What one thing do you like most about your dad?

5. What one thing do you like most about your mom?

6. What one thing do you like most about each of your brother(s) and/or sister(s)?

7. What is the biggest challenge you are currently facing in any area of your life?

8. If you could make one suggestion to your dad to improve his life, what would it be?

9. If you could make one suggestion to your mom to improve her life, what would it be?

10. What do you believe is the biggest challenge your family faces at this time?

11. What could you suggest that your parents do to improve their marriage?

12. What is your favorite food?

13. What is your favorite color?

14. What type(s) of music to you like?

15. What is your greatest fear?

16. What is your favorite free-time activity?

17. What is your favorite subject in school?

18. What is your favorite activity to do with your dad?

19. What is your favorite activity to do with your mom?

20. What is your favorite beverage?

21. What is your favorite sport?

22. What one activity do your friends participate in that concerns you the most?

E. Spiritual Growth

Prior to completing this portion of the survey, please review with parents or legal guardian for their permission.

1. Whom do you look to for spiritual guidance? Why do you look to this individual for guidance?

2. In what area have you seen spiritual growth during this evaluation period?

3. How do you believe your prayer life could reach a "10?"

4. What do you believe you could do to get your Bible study to a "10?"

5. Who assists you in your spiritual development and growth?

6. With whom do you share spiritual truths?

7. List one thing that others could do to assist you in your spiritual development.

8. Please rate the following people on a scale of 1 to 10 (10 is the best) for how much encouragement they give you in spiritual things.

Dad, Mom, Friends, Grandparents, Pastor(s),

Teachers, Others:

What could they do to get to a 10?

Dad:

Mom:

Friends:

Grandparents:

Pastor(s):

Teachers:

Others:

9. List one thing that currently is holding you back in your spiritual walk.

10. List one thing that you will try to do better over the next evaluation period that will improve your spiritual life.