Snapshot Test
            

PERSONAL DETAILS
Name: *
Email: *
State:*
  I would like to receive periodic information from the Personal Empowerment Institute.
Yes No *
  I would like to receive updates about events in the Newcastle Area.
Yes No *

1
Is there anything you are afraid of admitting?
2
Do you have difficulty in relationships?
3
Are you generally controlling with people you love?
4
Is there anybody you have not forgiven?
5
Do you have trouble knowing what you want?
6
In relationships do you share 100% of yourself with your partner?
7
Do you try to control your feelings most of the time?
8
Do you find yourself in frequent conflicts with people in authority?
9
Do you avoid conflict?
10
Do you feel guilty when you say no to someone?
11
Do you have trouble identifying what you are feeling at any given moment?
12
Do you sometimes feel that what you do is not good enough?
13
Do you believe you are responsible for other peoples feelings?
14
Is there any action you might be avoiding right now, that would change your life's destiny?
15
Would you do anything different if you knew you could not fail?
16
Is there anything you would regret in your life if you did not do it, if you knew your life was ending?
17
If you had a week left to live would you spend it with the people you are with now?
18
Do you know what you want, to live a fulfilled life?
19
Do you find yourself giving other people advise, that you yourself do not do?
20
Do you know your purpose in life?