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"Survey for Women" was made by chaplains.

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*** These question are serious and will help in writing several articles and a book I am preparing. ***
1. Please rate the following statements by how you would apply them to yourself, and as honestly as possible. No Answer
*** You may choose more than one in each category ***
2. but answer as simply as possible. No Answer
3. If you would like to write an explanation for your answers, you may. No Answer
4. All responses will be kept confidential. No Answer
*** Self-Image: ***
5. I am a Hottie no
6. I am Eye Candy no
7. I am Beautiful no
8. I am Good Looking no
9. I am Okay no
10. I am Not Attractive yes
11. I am Fat yes
12. I am a MILF I don't know what MILF is.
13. Other:___________ I am a cow.
*** I Dress the Way I Do, Because: ***
14. I feel like it yes
15. I want to yes
16. I need to no
17. I feel powerful when I do no
18. I love what I wear yes
19. I like the response I get, even if it's not the response I want no
20. Other:___________ It's comfortable
*** I Like It When: ***
21. Men look at my Pictures on MySpace no
22. Men get "excited" over my pictures on MySpace no
23. Men relate to me as a desirable female no
24. Men leave me messages about how "Hot" I am NO
25. Men pay any attention at all to me no
26. Men leave me alone yes
27. Other:___________ No Answer
*** It Bothers Me When: ***
28. I am posing in a way to illicit a response from men in pictures yes?
29. I men judge me as an object yes
30. I am treated as less than special not really
31. People don't seem to see the "real me" no, the real me is a sad and depressed person, I try not to display that.
32. Other:___________ No Answer
*** I am Happiest When: ***
33. I am appreciated yes
34. I am treated with respect yes
35. I am acknowledged no
36. I am loved no
37. I am sexy no
38. I am shopping no
39. I am successful yes
40. Other:___________ No Answer
*** What I Need Most in Life to Feel Fulfilled is: ***
41. Love no, right now love and other things just don't " fulfill" me
42. Respect yes
43. Happiness yes
44. Sex no
45. Money somewhat
46. Clothes yes
47. A Hug yes
48. Other:___________ No Answer
*** The Biggest "Pain" I Deal With is Because I was/Have Been ***
49. Lied to yes
50. Hurt yes
51. Abandoned yes
52. Injured yes
53. Raped yes
54. Victimized as a Child yes
55. Heartbroken yes
56. Other:___________ No Answer
*** I deal with the Following: ***
57. Addiction to medications/drugs (prescription or otherwise) yes
58. Alcohol yes
59. Over-eating no
60. Temper/Anger yes
61. Depression yes
62. Other:___________ eating disorder
*** My Biggest Fear Is: ***
63. I won’t be a success yes
64. I won’t be taken seriously yes
65. I’ll go unnoticed no
66. I won't be a good wife no
67. I won't be a good mother yes
68. I will never find a partner in life no
69. I made a mistake getting together with the one I'm with (married or not) no
70. I will never get married no
71. I will never find a partner who is "worthy of me" no
72. I am not worthy of being loved by someone yes
73. My children will not be well adjusted no
74. I am going to hurt my children no
75. I am going to hurt myself (or hurt myself again) yes
76. I am a powerful person no
77. I will be successful no
78. I will not know how to handle success when it comes yes
79. I am afraid of people yes
80. I am afraid of going outside sometimes, lately I am, b/c I have a stalker.
81. I am afraid of speaking in public very much
82. I am afraid of being raped (or raped again) very much
83. Other:___________ (see this list for some examples: http://www.phobialist.com/reverse.html) No Answer
*** I Prefer the Company of: ***
84. Men no
85. Women no
86. Teens no
87. Children no
88. Girls no
89. Boys no
90. Elderly no
91. Other:___________ No Answer
*** I My Perfect World I Would Be: ***
92. A Model yes
93. A Singer/Musician no
94. An Actor no
95. A Director no
96. A Manager no
97. A Mother no
98. A Bride no
99. Loved by Anyone no
100. Loved by Someone no
101. Find love that was real and lasting no
102. Other:___________ I would be 85 lbs, and perfect.