The BALANCE Experience Questionnaire

Name*

First NameLast Name

Email*

example@example.com

Phone Number

Describe yourself in five separate words (in no particular order)

	Descriptive Word
1
2
3
4
5

You can have three dinner guests (living or no longer with us). Who will you choose and why?

	Guest	Why?
1
2
3

Do you believe you have fundamentally changed as a person in the last 10 years? Select one answer below:

Not really - I’m pretty much the same person as I was a decade agoPerhaps a little – we all change over time, don’t we?A fair amount – a lot has happened to me in the last 10 yearsSignificantly different – I hardly recognise myself compared to a decade ago

Mark out of 10 (1 being ‘terrible’, 5 being average, ten being perfect) your current satisfaction level with:

	Enter any number between 1- 10
Work (your job or career)
Life partner
Relationship with close family
Circle of friends
Health
Money/income/wealth

You may decide to stop here and use the answers above to reflect on what you would like to improve in your life.

OR

You may wish to go a little deeper by answering part 2 below:

Name a song that has particular significance for you.

Song Title

Significance

Name a film that means something to you (and that you have seen more than three times).

Film Title

Significance

Name up to three of your life’s most significant events.

Event 1

Significance

Event 2

Significance

Event 3

Significance

What are you doing when you are at your happiest?

What makes you cry?

What makes you angry?

How do you relax?

According to the World Health Organisation, the average (western) life expectancy is under 1,000 months. Please calculate and write down how many months you have been alive

I have been alive for how many? months.

If you knew you were going to die in exactly 12 months from today, score how differently would you live your life over the next year? (1 being not much difference at all, 5 being half of what I do would change, 10 being everything I do would change).

Your score out of 10:

What would you do if you knew you couldn’t fail?

Thinking about what a personal development course might bring you, put these in order of importance to you. 1 being the most important to you, 6 being the least important to you.

Put these in order (1 = most important)

	Enter a number between 1 & 6
Increase mental resilience (The ability to endure or generate change in your life and to feel more able to cope better, feeling more in control)
Improve important relationships (Creating new relationships, deepening existing relationships, repairing broken relationships, or forgiving self/others)
Develop more confidence (This may be relating to a specific issue like ‘imposter syndrome’, or general self-esteem displayed as inner or outer confidence – or both)
Reduce stress (The ability to deal with negative emotions, generate calm in self and others, release worry or anxiety - and have fun!)
Identify priorities (Helping to review, understand and act on those things in your life that are most important to you and those closest to you)
Become happier (A marked change in your subjective well-being, contentment, and general peace of mind which would be noticed by others)

INSTRUCTIONS

As with other sections of the questionnaire, this exercise has no right or wrong answers.

If you decide to submit your full questionnaire and book a call with Andy, you will receive a 2 page profile based on the answers you provide here. The profile is yours whether or not you attend BALANCE.

How to complete this section:

Consider the words/descriptors and decide which set is MOST like you and check the M box.

Consider which set of words is LEAST like you and check the L box.

Assign a value of 1, 2 or 3 to the other two word sets according to how accurately they describe you and check the appropriate box (1,2 or 3).

You must check four boxes and no boxes may have the same value as another.

Try not to think too hard about your answers – usually your first/instinctive choice is the best one. This exercise should take you less than 5 minutes

Type a question

	Least	1	2	3	Most
Reliable, attentive, and tolerant
Demonstrating, persuasive, and sociable
Composed, observing, and systematic
Challenging, brave, and opinionated

	Least	1	2	3	Most
Supportive, considerate, and sympathetic
Detached, impartial, and discreet
Purposeful, straight-talking, and commanding
Enthusiastic, talkative, and optimistic

	Least	1	2	3	Most
Lively, unreserved, and witty
Reasoning, logical, and methodical
Calming, tactful, and moderate
Assertive, daring, and dominant

	Least	1	2	3	Most
Precise, deliberate, and well-prepared
Direct, determined, and competitive
Warm-hearted, thoughtful, and diplomatic
Open, outgoing, and light-hearted

	Least	1	2	3	Most
Even-tempered, loyal, and accommodating
Private, reserved, and meticulous
Spirited, animated, and passionate
Active, controlling, and results-oriented

	Least	1	2	3	Most
Cautious, realistic, and factual
Focused, independent, and strong-willed
Stable, concerned, and appreciative
Expressive, dynamic, and friendly

The answers you have given to Part 3 allow me to understand your personality type. If you would like to receive the 2 page psychometric profile that your answers generate, then move on to Part 4 below:

The BALANCE Experience questionnaire has been designed to help you review some of those things we sometimes put to the back of our minds. PERHAPS IT HAS DONE ITS JOB AND HAS MADE YOU THINK... In which case I wish you all the best in creating your own ‘Life Well Lived’.

Andy Edwards: APPLY TO BE A DELEGATE

However, if you want to accelerate your results and recognise how important it is to invest in yourself – and you are prepared to spend a little time and money on the most important person in the world (you), then submit your questionnaire for potential acceptance onto the next suitable BALANCE course.

On submission of your questionnaire, you will receive an invitation for a ‘Discovery’ telephone (or zoom/teams) conversation with me, Andy Edwards. Lasting between 20 and 30 minutes, you get the chance to go through parts of your questionnaire with me – and get some complimentary coaching on the way!

This is not a sales call as I will already assume you would like to attend BALANCE. However, there may be some good reasons why you should NOT attend, which will be explored. Bear in mind, even if you want to attend a BALANCE course, you may still be refused a place (around 10% of people are declined) for which you will receive a full reason.

The 2 page profile generated by your answers in section 3 will be sent to you regardless of the outcome of the Discovery call.

So, now it’s over to you. If you would like to take a step closer to attending, then simply submit your completed questionnaire and I'll be in touch.

Are you ready for your BALANCE Experience?

To receive an email with your answers in PDF form, please check the box below

Yes, I consent to having my answers sent to the email address provided

The BALANCE Experience Questionnaire

SECTION 1: YOU

SECTION 2: A LITTLE DEEPER

SECTION 3: YOUR PERSONALITY STYLE

SECTION 4: APPLY TO BE A DELEGATE