Name
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First Name
Last Name
Email
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Schools and Universities 1
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Please list your diplomas:
Schools and Universities 2
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Please list your degrees:
Schools and Universities 3
Please list your awards and honors:
Schools and Universities 4
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Please list your academic strengths:
Interests, Skills and Activities 1
Please list your arts, music and sports interests and activities:
Interests, Skills and Activities 2
Please list your civic and professional organizations:
Interests, Skills and Activities 3
Please list your skills:
Interests, Skills and Activities 4
Please list your languages spoken:
Interests, Skills and Activities 5
Please list your certifications:
Interests, Skills and Activities 6
Please list your awards and honors:
Interests, Skills and Activities 7
Please any other interests, skills or activities:
Employment 1
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Please list all of your current employment:
Employment 2
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Please list all of your prior employment, in chronological order:
Business Investment 1
Please list your business investments in which you play an active leadership role:
Business Investment 2
Please describe your active leadership role(s):
Promotion and Advancement 4
Please list your awards and honors:
Your First Major Magazine Interview 1
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How would you describe your upbringing - family, friends, school, etc.?
Your First Major Magazine Interview 2
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Were you popular in school and/or among your friends?
Your First Major Magazine Interview 3
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Was there a pivotal event or events that have helped to define you?
Your First Major Magazine Interview 4
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When did you start to realize your talents and how did they develop?
Your First Major Magazine Interview 5
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Did you have any mentors or role models coming up?
Your First Major Magazine Interview 6
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What is your vision for today and the future?
Your First Major Magazine Interview 7
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Who and what do you love?
Your First Major Magazine Interview 8
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So, what drives you now?
Your First Major Magazine Interview 9
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What's next for you?
Personal Life Map
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Please list the significant events of your personal life and their individual satisfaction ratings with 0 = Low Satisfaction, 5 = Average and 10 = High. Example: engagement / 8, birth of a child / 10, reaching a fitness goal / 7, death of a family member / 1, marriage break-up / 2, major illness / 2
Professional Life Map
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Please list the significant events of your professional life and their individual satisfaction ratings with 0 = Low Satisfaction, 5 = Average and 10 = High. Examples: college admission / 8, graduation / 10, first job / 7, promotion / 8, job loss / 1, major conflict / 2, job transfer / 2, changing career / 8
Your Best Qualities
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What are your best personal and professional qualities and talents?
What do others recognize as your greatest strengths?
List only three (3) in order of importance:
Your Biggest Obstacles
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What are your most critical weaknesses?
What will get you into trouble in your career? (Think about what others might say)
List only three (3) in order of importance:
Chart Your Course 1
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What do you want to accomplish in your life?
Chart Your Course 2
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What will make you happy?
Chart Your Course 3
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What values are most important to you?
Chart Your Course 4
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What would you like to be known for?
Charted Course: Action #1
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Based on your charted course, list the actions you need to take to realize your new direction?
Please list 1 of 5 actions:
Charted Course: Action #2
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Based on your charted course, list the actions you need to take to realize your new direction?
Please list 2 of 5 actions:
Charted Course: Action #3
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Based on your charted course, list the actions you need to take to realize your new direction?
Please list 3 of 5 actions:
Charted Course: Action #4
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Based on your charted course, list the actions you need to take to realize your new direction?
Please list 4 of 5 actions:
Charted Course: Action #5
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Based on your charted course, list the actions you need to take to realize your new direction?
Please list 5 of 5 actions: