Adult Application & Discovery Questionaire


Name: *
Phone: *
Email: *
Age: *
Male Female 
What is the reason you want to learn more about your Natural Abilities?
What work are you currently doing?
Do you enjoy your current work?
 Yes No
If Yes, What do you enjoy?
If No, What do you dislike?
Are you looking for a change in your career?
Yes No 
Please list other jobs you have had that you enjoyed or disliked:

Do you currently or have you in the past had conflicts with other workmates, staff or bosses in the past?
Yes No 
What are your hobbies, interest, what you like to do out of work?
When you were a child, what or who did you want to be when you grew up? And Why?
If you knew you could not fail, success was guaranteed, what career would you pursue?
What work would you be happy to do with no pay?
Please list 3 strengths:
Please list 3 weaknesses:
Are there any personal issues in your life that I should know about to which may affect your results or the counselling session? Please list:
Do you have any learning disabilities, on any medication or are there any other learning, medical, or behavioural issues that I should know about? Please List: