The Success Strategy Survey takes just a few minutes to complete.  It is designed to help us get to know you in a short amount of time.  There are no right or wrong answers, and there is no time limit.  Please try to complete the form at one sitting and free from distractions.  Thank you for your time and your interest.
 
1. Name :
2. Date :
3. Company you are interviewing with :
4. Position you are interviewing for :

 

EMPLOYMENT


5.        Start with your present or most recent position:
Company
Responsibilities
Employed from
To
Monthly earnings  $
 
Company
Responsibilities
Employed from
To
Monthly earnings  $
 
Company
Responsibilities
Employed from
To
Monthly earnings
 

Indicate how you think your past employers will describe you

Serious

Weakness

Minor

Weakness

Not a Strength

or Weakness

Minor

Strength

Primary

Strength

Ability to solve problems independently
Following instructions from management
Volunteering to do extra work
Getting along with many different kinds of people
Remaining diplomatic when disagreements arise

Serious

Weakness

Minor

Weakness

Not a Strength

or Weakness

Minor

Strength

Primary

Strength

Acting decisively to get quick results
Accuracy and completeness in paperwork
Helping keep morale high
Handling a wide variety of duties
Ability to communicate effectively with others

Serious

Weakness

Minor

Weakness

Not a Strength

or Weakness

Minor

Strength

Primary

Strength

Taking the lead with other people
Maintaining a high level of organization
Staying positive when things go wrong
Adjusting quickly to changes
Skill in handling people-problems

Serious

Weakness

Minor

Weakness

Not a Strength

or Weakness

Minor

Strength

Primary

Strength

Being firm or assertive with others
Handling details with precision
Consistency of mood
Solving a variety of problems
Building close working relationships

Serious

Weakness

Minor

Weakness

Not a Strength

or Weakness

Minor

Strength

Primary

Strength

Using persuasive skill to influence others
Punctuality in getting to work and appointments
Putting in extra hours when needed
Versatility in performing different tasks
Working cooperatively with other people

 

  

Indicate all of the words or phrases YOU FEEL DESCRIBE YOU

 

Direct
Sociable
Patient
Thorough
Energetic
Reliable
Cheerful
Skeptical
Flexible
Decisive
Expressive
Predictable
Orderly
Active
Steady
Optimistic
Cynical
Versatile performer
Aggressive
Good mixer
Soft-spoken
Accurate
Decision-maker
Self-disciplined
Positive attitude
Critical
Adaptable
Independent
Openly warm
Mild-mannered
Perfectionist
Ambitious
Good follow-through
Happy
Suspicious
Many skills
Forceful
Love to chat
Don't like change
Picky
Initiator
Consistent
Trusting
A realist
Multi-talented
Controlling
People-person
Accommodating
Detailed
A leader
Dependable
Confident
Cautious
Jack of all trades
Stubborn
Entertaining
Discreet
Precise
Impatient
Efficient
Hopeful
Worrier
Can handle anything
Demanding
Popular
Amiable
Careful
Problem-solver
Conscientious
Can-do attitude
Sarcastic
Lots of abilities
Bold
Outgoing
Obliging
Meticulous
Enterprising
Industrious
Expect the best
Not very trusting
Can handle anything
Assertive
Talkative
Easy-going
Well-organized
Takes-on too much
Fussy
Too trusting
Defensive
Versatile

 

 

 Indicate the words or phrases you feel OTHERS WOULD USE TO DESCRIBE YOU

 

Direct
Sociable
Patient
Thorough
Team-player
Intelligent
Creative
Traditional
Sometimes negative
Decisive
Expressive
Predictable
Orderly
Supportive
Resourceful
Original
Conventional
Opinionated
Aggressive
Good-mixer
Soft-Spoken
Accurate
Considerate
Logical
Imaginative
Cautious
Aloof
Independent
Openly warm
Mild-mannered
Perfectionist
Cooperative
Analytic
Adventurous
Accepting
Moody
Forceful
Love to chat
Don't like change
Picky
Helpful
Factual
Unconventional
Follow the rules
Sarcastic
Controlling
People-person
Accommodating
Detailed
Thoughtful
Reasoning
Artistic
Don't rock the boat
Bossy
Stubborn
Entertaining
Discreet
Precise
Loyal
Clear-thinking
Unpredictable
Mild
Sometimes gossip
Demanding
Popular
Amiable
Careful
Competent
Fair-minded
Innovative
Hesitant
Don't like to hurry
Bold
Outgoing
Obliging
Meticulous
Receptive
Open-minded
Daring
Contented
Have a temper
Assertive
Talkative
Easy-going
Well-organized
Diplomatic
Methodical
Non-conformist
Predictable
Hold things inside

  

 

  Indicate the ONE word in each box that best describes you

 

Bold
Cheerful
Consistent
Aggressive
Outgoing
Reliable
Accurate
Popular
Controlling
Talkative
Quiet
Decisive
Expressive
Assertive
Discreet
Too trusting
Perfectionist
Argumentative
Spontaneous
Cautious
Impulsive
Effective
Influential
Orderly
Knowledgeable
Direct
Entertaining
Steady
Demanding
Charming
Insistent
Methodical
Sociable
Careful
Forceful
Playful

 

 
           10. What are your primary strengths as an achiever?

 

 
  11.          How could you be even more effective as an achiever?