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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. =
*** You may choose more than one in each category ***
2. but answer as simply as possible. =
3. If you would like to write an explanation for your answers, you may. =
4. All responses will be kept confidential. =
*** Self-Image: ***
5. I am a Hottie No
6. I am Eye Candy No
7. I am Beautiful No.
8. I am Good Looking On good days.
9. I am Okay On most days.
10. I am Not Attractive On some days.
11. I am Fat I am.
12. I am a MILF Ha-I don't meet the requirements.
13. Other:___________ =
*** 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 Yes.
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:___________ =
*** I Like It When: ***
21. Men look at my Pictures on MySpace =
22. Men get "excited" over my pictures on MySpace No.
23. Men relate to me as a desirable female Yeah, but they don't.
24. Men leave me messages about how "Hot" I am =
25. Men pay any attention at all to me They do, but because I'm cool, not because I'm hot.
26. Men leave me alone Lol!
27. Other:___________ =
*** It Bothers Me When: ***
28. I am posing in a way to illicit a response from men in pictures Ha, ya think?
29. I men judge me as an object Yes.
30. I am treated as less than special Sure.
31. People don't seem to see the "real me" Whatever.
32. Other:___________ =
*** 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 Me? Lol.
38. I am shopping Never.
39. I am successful Ok.
40. Other:___________ =
*** What I Need Most in Life to Feel Fulfilled is: ***
41. Love Of some sort.
42. Respect Yes.
43. Happiness Yes.
44. Sex No.
45. Money Yes.
46. Clothes No.
47. A Hug Yes
48. Other:___________ =
*** 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:___________ =
*** I deal with the Following: ***
57. Addiction to medications/drugs (prescription or otherwise) Yes- rehab for 11 months.
58. Alcohol Yes- rehab.
59. Over-eating No.
60. Temper/Anger Yes-rehab.
61. Depression Yes.
62. Other:___________ =
*** My Biggest Fear Is: ***
63. I won’t be a success Yes.
64. I won’t be taken seriously No.
65. I’ll go unnoticed No.
66. I won't be a good wife No.
67. I won't be a good mother No.
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 =
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 How is that a fear?
77. I will be successful No Answer
78. I will not know how to handle success when it comes No.
79. I am afraid of people No
80. I am afraid of going outside No
81. I am afraid of speaking in public No
82. I am afraid of being raped (or raped again) Yes
83. Other:___________ (see this list for some examples: http://www.phobialist.com/reverse.html) =
*** I Prefer the Company of: ***
84. Men Yes.
85. Women No.
86. Teens No.
87. Children No.
88. Girls No.
89. Boys No.
90. Elderly No.
91. Other:___________ =
*** I My Perfect World I Would Be: ***
92. A Model No.
93. A Singer/Musician Maybe.
94. An Actor Yes.
95. A Director No.
96. A Manager Maybe.
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 Sure
102. Other:___________ =