STEVENSON & ASSOCIATES, INC.

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ProScanT Survey Card (400 Series)

DIRECTIONS: Mark the response which best describes HOW YOU FEEL YOU REALLY ARE on a scale from 1 to 5, with 1 being NO OR LEAST and 5 being YES OR MOST.

No......................................Yes

1 Trustworthy

1 2 3 4 5

2 Gentle

1 2 3 4 5

3 Spirited

1 2 3 4 5

4 Understanding

1 2 3 4 5

5 Individualistic

1 2 3 4 5

6 Esteemed

1 2 3 4 5

7 Earnest

1 2 3 4 5

8 Compassionate

1 2 3 4 5

9 Convincing

1 2 3 4 5

10 Bold

1 2 3 4 5

11 Precise

1 2 3 4 5

12 Adaptable

1 2 3 4 5

13 Organized

1 2 3 4 5

14 Aggressive

1 2 3 4 5

15 Shy

1 2 3 4 5

16 Compelling

1 2 3 4 5

17 Calm

1 2 3 4 5

18 Daring

1 2 3 4 5

19 Spontaneous

1 2 3 4 5

20 Outgoing

1 2 3 4 5

21 Fussy

1 2 3 4 5

22 Talkative

1 2 3 4 5

23 Demanding

1 2 3 4 5

24 Industrious

1 2 3 4 5

25 Generous

1 2 3 4 5

26 Careful

1 2 3 4 5

27 Pleasant

1 2 3 4 5

28 Conventional

1 2 3 4 5

29 Warm

1 2 3 4 5

30 Efficient

1 2 3 4 5

Note NEW
DIRECTIONS: Mark the response which best describes HOW YOU FEEL OTHERS EXPECT YOU TO BE OR ACT on a scale from 1 to 5, with 1 being NO OR LEAST and 5 being YES OR MOST.

Personal Information:

First Name: Last Name:

Company Name: Dept.

Title/Position:

Address: Suite:

City: State:

Zip Code: Phone:

Manager:

Email Address:

How did you hear about us?

If referred by a customer or representative,
please tell us their name.

Which challenges are concerns?

(You may make more than one selection, Ctrl + click.)

Comments:

ï¿½PDP, Inc. Woodland Park, CO, 2000 (Rev. 1997)