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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 Answer
6. I am Eye Candy No Answer
7. I am Beautiful in some ways
8. I am Good Looking i can be
9. I am Okay usually just okay
10. I am Not Attractive sometimes when i look closely at myself
11. I am Fat my legs are
12. I am a MILF No Answer
13. Other:___________ im chubby, but in a cute way i guess
*** I Dress the Way I Do, Because: ***
14. I feel like it yeah
15. I want to yeah
16. I need to sometimes
17. I feel powerful when I do No Answer
18. I love what I wear when i fit into it
19. I like the response I get, even if it's not the response I want No Answer
20. Other:___________ if its comfortable ill wear it
*** I Like It When: ***
21. Men look at my Pictures on MySpace it means im worth looking at
22. Men get "excited" over my pictures on MySpace No Answer
23. Men relate to me as a desirable female its nice
24. Men leave me messages about how "Hot" I am No Answer
25. Men pay any attention at all to me its nice sometimes
26. Men leave me alone No Answer
27. Other:___________ i like compliments every now and then
*** It Bothers Me When: ***
28. I am posing in a way to illicit a response from men in pictures No Answer
29. I men judge me as an object sometimes
30. I am treated as less than special No Answer
31. People don't seem to see the "real me" sometimes
32. Other:___________ i feel like i have different personalities for different people
*** 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 No Answer
38. I am shopping sometimes
39. I am successful No Answer
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 yes
45. Money yes
46. Clothes yes
47. A Hug yes
48. Other:___________ someone to talk to
*** The Biggest "Pain" I Deal With is Because I was/Have Been ***
49. Lied to yes
50. Hurt yes
51. Abandoned No Answer
52. Injured No Answer
53. Raped No Answer
54. Victimized as a Child No Answer
55. Heartbroken yes
56. Other:___________ the first person that took my virginity died of an overdose
*** I deal with the Following: ***
57. Addiction to medications/drugs (prescription or otherwise) No Answer
58. Alcohol when i feel like i cant have fun any other way
59. Over-eating when im upset
60. Temper/Anger No Answer
61. Depression sometimes
62. Other:___________ No Answer
*** My Biggest Fear Is: ***
63. I won’t be a success No Answer
64. I won’t be taken seriously No Answer
65. I’ll go unnoticed yes
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 yes
69. I made a mistake getting together with the one I'm with (married or not) No Answer
70. I will never get married yes
71. I will never find a partner who is "worthy of me" No Answer
72. I am not worthy of being loved by someone yes
73. My children will not be well adjusted No Answer
74. I am going to hurt my children No Answer
75. I am going to hurt myself (or hurt myself again) yes
76. I am a powerful person No Answer
77. I will be successful No Answer
78. I will not know how to handle success when it comes No Answer
79. I am afraid of people yes
80. I am afraid of going outside No Answer
81. I am afraid of speaking in public No Answer
82. I am afraid of being raped (or raped again) No Answer
83. Other:___________ (see this list for some examples: http://www.phobialist.com/reverse.html) death, dead people, dying
*** I Prefer the Company of: ***
84. Men yes
85. Women yes
86. Teens yes
87. Children No Answer
88. Girls No Answer
89. Boys yes
90. Elderly No Answer
91. Other:___________ No Answer
*** I My Perfect World I Would Be: ***
92. A Model No Answer
93. A Singer/Musician No Answer
94. An Actor No Answer
95. A Director No Answer
96. A Manager No Answer
97. A Mother yes
98. A Bride yes
99. Loved by Anyone No Answer
100. Loved by Someone yes
101. Find love that was real and lasting yes
102. Other:___________ No Answer