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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 To my husband
8. I am Good Looking Yes
9. I am Okay Yes
10. I am Not Attractive Not Ugly but Not Perfect
11. I am Fat Not fat but too big
12. I am a MILF No Answer
13. Other:___________ Unique
*** I Dress the Way I Do, Because: ***
14. I feel like it no
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:___________ jeans and t-shirt kind of girl
*** 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 Not on the market...No
24. Men leave me messages about how "Hot" I am No
25. Men pay any attention at all to me looks are ok they make you feel good inside when they acknowledge you are there
26. Men leave me alone Yes haha
27. Other:___________ Married Woman
*** It Bothers Me When: ***
28. I am posing in a way to illicit a response from men in pictures don't pose
29. I men judge me as an object yes
30. I am treated as less than special no
31. People don't seem to see the "real me" no
32. Other:___________ No Answer
*** I am Happiest When: ***
33. I am appreciated yes
34. I am treated with respect yes
35. I am acknowledged yes
36. I am loved yes
37. I am sexy from my husband yes any other inappropriate
38. I am shopping No Answer
39. I am successful YES
40. Other:___________ No Answer
*** What I Need Most in Life to Feel Fulfilled is: ***
41. Love yes
42. Respect yes
43. Happiness yes
44. Sex no
45. Money no
46. Clothes no
47. A Hug sometimes
48. Other:___________ Good Health
*** The Biggest "Pain" I Deal With is Because I was/Have Been ***
49. Lied to at one point yes
50. Hurt emotionally
51. Abandoned I felt that way when I lost a family member
52. Injured no
53. Raped luckily no
54. Victimized as a Child God Bless those who have been but no
55. Heartbroken yes (#51)
56. Other:___________ No Answer
*** I deal with the Following: ***
57. Addiction to medications/drugs (prescription or otherwise) no
58. Alcohol no
59. Over-eating sometimes
60. Temper/Anger temper at times
61. Depression no
62. Other:___________ No Answer
*** 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 yes
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 no
73. My children will not be well adjusted n/a
74. I am going to hurt my children NO
75. I am going to hurt myself (or hurt myself again) NO
76. I am a powerful person Not a fear
77. I will be successful Not a fear
78. I will not know how to handle success when it comes Not a fear
79. I am afraid of people Not a fear
80. I am afraid of going outside Not a fear
81. I am afraid of speaking in public Not a fear
82. I am afraid of being raped (or raped again) havn't been, I do take precautions but not always something in the back of my mind
83. Other:___________ (see this list for some examples: http://www.phobialist.com/reverse.html) No Answer
*** I Prefer the Company of: ***
84. Men my better half
85. Women Mother and best friend
86. Teens family
87. Children YES
88. Girls No Answer
89. Boys No Answer
90. Elderly YES
91. Other:___________ No Answer
*** I My Perfect World I Would Be: ***
92. A Model no
93. A Singer/Musician no
94. An Actor no
95. A Director no
96. A Manager no
97. A Mother yes
98. A Bride yes
99. Loved by Anyone no
100. Loved by Someone yes
101. Find love that was real and lasting yes
102. Other:___________ No Answer