We're Really Looking Forward to Welcoming You to Our
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THE REINVENTION UNIVERSITY
ENROLLMENT QUESTIONNAIRE Welcome
• If you've decided to enrol, then thank you – and congratulations! – We're really looking forward to welcoming you to our Reinvention University and help you to transform your life. You'll be joining a special group of people who have chosen to change their own lives - and those of others - for the better.
ww w .he a l t h y l i f e s t y l eslivi n g. c om The Reinvention University Enrolment Questionnaire Your full, legal name
Your preferred first name
Preferred Title Ms/Miss/Mrs/Mr
Age
Gender Male/Female
Country
Skype
Time Availablity. In order to accommodate your schedule, please list days and times that work best for your hourly session What is your MAIN activity or occupation in the year prior to enrolling for this course? Welcome
• Please complete the enrolment questionnaire answering all questions truthfully so that we can ensure the course is right for you, and you are right for the course. • - There are no right or wrong answers.
ww w .he a l t h y l i f e s t y l eslivi n g. c om The Reinvention University Enrolment Questionnaire Why do you believe you were drawn to this program. What are you hoping to get out of it?
Type Here What are your expectations of your Mentor on this course?
Type Here Make a list of five things that you would like to change or create in your life?
Type Here What one thing,if it were different or better, would make the greatest difference in your life right now?
Type Here Please list three (3) things in your life that motivate you to take action?
Type Here What would reinvention mean to you?
Type Here How important is it to you?
Type Here What do I want my life to be about?
We all have principles that guide our life, whether we are aware of them or not. Each person has different principles. Please rate the extent each principle is personally important to you. We would like to know what you find important, not necessarily what others find important.
Rating Scale:
1 2 3 4 5 6 7 8 9
Unimportant to Me Extremely Important To Me Principle Rating
1 Having an exciting life
2 Being ambitious and hardworking
3 Connecting with nature
4 Acting consistently with my beliefs
5 Enjoying music, art, and/or drama
6 Having an enjoyable, leisurely life
7 Being wealthy
8 Being loyal to friends, family, and/or my group
9 Being self-disciplined and resisting temptation
10 Designing things
11 Being Creative
12 Being physically fit
13 Gaining wisdom
14 Maintaining the security of my loved ones Principle Rating
29 Making sure to repay favors and not be indebted to people 30 Working with my hands
31 Having a life filled with novelty and change
32 Eating healthy food
33 Promoting justice and caring for the weak
34 Showing respect for tradition
35 Organizing things
36 Feeling good about myself
37 Having genuine and close friends
38 Meeting my obligations
39 Engaging in clearly defined work
40 Being curious, discovering new things
41 Having a sense of accomplishment and making a lasting contribution 42 Having relationships involving love and affection Welcome
• We agree to meet regularly through the 12 weeks. At the end of this time, we will review our time together, evaluate your progress and reach a learning conclusion. Once we have agreed on this, the relationship will be considered complete. However, if we choose to continue the mentoring partnership, we may negotiate a basis for continuation, as long as we have stipulated mutually agreed terms and goals.
• Enjoy the course
ww w .he a l t h y l i f e s t y l eslivi n g. c om The Reinvention University Enrolment Questionnaire Thww wa. heanklt hyli fes t yleslY i viou!ng.com