Name (Last, First, MI):

Date (MM/DD/YY): //

School: Grade:

e-mail (if available):

Split 4 possible points among the three available responses to each statement. Each point represents the degree of comfort you have with a particular option. A maximum of 4 points represents the greatest possible comfort where as a 0 represents the least possible comfort. All numbers must be whole numbers - for example a split could be 1-2-1 or 0-3-1 or 4-0-0 or any other combination totaling 4.

1. When faced with a large project, I prefer to . . .

A. know what is expected of me.

B. work as part of a group.

C. decide for myself what to do.

2. When learning a new task, I prefer to . . .

A. experiment until I get it right.

B. know the specific steps required.

C. have someone walk me through it.

3. When making plans with friends, I . . .

A. like to have things clear well in advance.

B. like to "go with the flow" and see what happens.

C. consider what everyone wants to do.

4. When selecting an after-school activity, I like to . . .

A. choose something I've never tried before.

B. do something where I can be with others.

C. choose something familiar.

5. When studying, I . . .

A. wait until the last minute.

B. schedule sufficient time.

C. study with another person.

6. About people, I remember ________ most easily.

A. my first impression.

B. faces.

C. personalities.

7. When I meet someone new, I like to . . .

A. find out his/her goals.

B. invite him/her to join my group.

C. share details about each other.

8. When giving a presentation, I like to . . .

A. have notes available as a reference.

B. involve the rest of the class.

C. talk off the top of my head.

9. I use the Internet mostly for . . .

A. creative activities.

B. chatting with friends.

C. looking up information.

10. When I accomplish something important, I like to . . .

A. think of ways to do it better.

B. celebrate with friends.

C. take notes so I can repeat it in the future.

11. When I have free time, I like to . . .

A. find something new to do.

B. hang out with friends.

C. make sure everything is done.

12. My favorite type of game is one . . .

A. where I have to achieve a goal.

B. where I interact with others.

C. that allows me to use my imagination.

13. When electing an officer for school council, I vote for the one . . .

A. I like the most.

B. most qualified.

C. with the best plan for the school.

14. When doing chores, I prefer to . . .

A. do them as I get to them.

B. try to get others to help.

C. start by making a to-do list.

15. I want a job where I can . . .

A. have an effect on people.

B. be an innovator.

C. enjoy job security.

16. I like to be praised for . . .

A. teamwork.

B. a job well done.

C. my creativity.

17. When in a role-playing exercise, I like to . . .

A. try different approaches.

B. know as much about my role as possible.

C. engage with others.

18. When trying to convince my parents to let me do something, I . . .

A. try to explain why it is important to me.

B. show them the pros and cons.

C. talk about how it will work.

19. When choosing a project topic, I . . .

A. like to do something unique.

B. like to work on a team.

C. pick something I already know about.

20. When thinking about a job for the future, I look forward to . . .

A. gaining work experience.

B. making money.

C. being with new people.

21. I prefer clothes that . . .

A. people will compliment.

B. are reasonably priced.

C. show my own unique style.

22. When dealing with rumors, I . . .

A. I think of how it may impact a situation.

B. share and discuss it with friends.

C. want to know if it is true.

23. When I'm feeling down, I like to . . .

A. deal with it in my own way.

B. talk with friends.

C. do something to distract me.

24. When getting ready for school in the morning, I . . .

A. think about the day ahead.

B. try to touch base with others.

C. follow a set routine.

25. When I make a decision, I . . .

A. think about all the choices.

B. consider the effect on people.

C. consider the facts.

Normally we are provided with the names of expected respondents by those who have requested that you complete the inventory. Results will be forwarded to you through that individual or delivered in a QWLC workshop. If you are completing the Inventory independently, please give us us a mailing address or similar instructions in the space below.

Special Instructions:

You will be provided with a copy of your answers to this inventory and provided the opportunity to return to this page and all the fields to a blank entry.

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