PERSONAL
Name:
Address:
Place of birth:
Date of birth:
Astrological sign:
What have you learned?
What has become of you?
Height: Weight:
Hair color: Eye color:
Distinguishing marks:
Your life philosophy:
Today’s date:
HISTORICAL
Mother’s full name:
Mother’s maiden name:
Date of birth:
Father’s full name:
Date of birth:
Siblings’ names: Dates of birth:
__________________________________________
__________________________________________
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Names of maternal grandparents:
Names of paternal grandparents:
Mother’s family comes from:
Father’s family comes from:
Famous or notable relative or ancestor:
FAVORITES
Although you may not wish to make a decision, just give it a try.
A color you like to wear:
An animal you would like to own as a pet:
A flower you would like to grow in your garden:
Your lucky number:
A smell that makes you pause:
A taste that makes you melt:
What do you like to occupy yourself with?
A sport you enjoy watching:
A sport you enjoy playing:
A city you visit regularly:
A country you like to explore:
FAVORITES
Your meal:
Your drink:
Your dessert:
A game you like to play:
A book you recommend:
An author who has affected you:
A magazine you read:
A newspaper you read:
Music when you are alone:
What music you currently listen to:
A film you could watch over and over:
A good director:
FAVORITES
A good actress:
A good actor:
The best TV show:
An artist you like:
A piece of clothing you like to wear:
What would you like to see from your bedroom window?
Your favorite time of day:
Your favorite place at home:
What do you do on a Sunday?
What you have always liked:
THE FRUITS OF YOUR LABOR
Your children: Ages:
Your pet:
Your accommodation:
Your transportation:
Your approximate annual income:
( ) You are making more money than ever before.
( ) You always thought you would make more money.
( ) You never expected to make this much money.
Number of hours you spend working each week:
( ) You work too little.( ) You work too much.
THE FRUITS OF YOUR LABOR
Your watch:
Your fragrance:
Something special on your desk:
What hangs on your wall?
What you hide under your bed or in your closet:
Something on your night table:
When you sleep, you wear
What you would keep in a safe:
What you like spending money on:
If you could afford it:
You collect:
What you have too little of:
THE FRUITS OF YOUR LABOR
Your strangest possession:
Your most expensive possession:
Something that is precious to you:
Material possessions are
If your house was burning, you would rescue these three things:
1
2
3
MORALS
You did something forbidden that might surprise your closest friends:
People should not marry before this age:
People should not have children before this age:
The appropriate age for having sex:
When did you have sex for the first time?
Your most recent lie:
When you are late for an appointment, you
( ) tell a white lie.( ) tell the truth.
A lie you tell yourself:
Something you have stolen that was not worth the risk:
MORALS
Someone you would like to really beat up:
Something that’s addictive to you:
Do you take drugs or alcoholic beverages on a regular basis?( ) Yes( ) No
If there were no side effects, you would enjoy being addicted to:
A drug you have tried in the past:
A drug you would never try:
A drug you will never try again:
Hitting a child is an appropriate form of discipline.( ) Yes( ) No
MORALS
Have you ever hit a woman?( ) Yes( ) No
If yes, why?
Have you ever hit a man?( ) Yes( ) No
If yes, why?
Have you been arrested?( ) Yes( ) No
If yes, for what?
You have read someone’s diary or gone through someone’s private belongings.( ) Yes( ) No
If yes, what was the reason?
( ) Jealousy( ) Distrust( ) Curiosity
( ) You were asked by someone else to do it.
What did you discover?
MORALS
What would your reaction be if your partner cheated on you?
You have cheated.( ) Yes( ) No
Has there ever been a time in your life when you hurt someone on purpose?( ) Yes( ) No
Did you apologize?( ) Yes( ) No
Have you ever hurt someone by accident?( ) Yes( ) No
Did you apologize?( ) Yes( ) No
You owe someone money but have stalled in paying it back.( ) Yes( ) No
If yes, what is the amount?
GOD AND THE WORLD
Do you believe in God?( ) Yes( ) No
Describe God:
What religion were you raised with?
Do you practice this religion?( ) Yes( ) No
Your most spiritual moment:
That last time you were in a house of worship:
Death is:
How you picture the end of the world:
God has spoken to you.( ) Yes( ) No
If yes, what did God tell you?
GOD AND THE WORLD
Are wars and religion connected?( ) Yes( ) No
Does life exist on other planets?( ) Yes( ) No
Have they made contact with us?( ) Yes( ) No
Do you believe we are descendants of Adam and Eve?( ) Yes( ) No
Do you believe in evolution?( ) Yes( ) No
Do you believe in astrology?( ) Yes( ) No
Do you read your horoscope?( ) Yes( ) No
If yes, why?
Have you ever been treated by a psychotherapist?( ) Yes( ) No
If yes, why?
Do you believe in reincarnation?( ) Yes( ) No
If yes, how would you like to come back?
OPINIONS
What is your opinion of
the right to have an abortion:( ) Pro( ) Con
the right to own guns:( ) Pro( ) Con
the welfare system:( ) Pro( ) Con
the death penalty:( ) Pro( ) Con
illegal immigration:( ) Pro( ) Con
the legalization of drugs:( ) Pro( ) Con
same-sex marriage:( ) Pro( ) Con
Which issue concerns you the most, or is there another one?
On behalf of this issue, you have
( ) donated time.( ) donated money.( ) done nothing.
OPINIONS
The first step toward resolving poverty:
The first step toward resolving racism:
The environmental issue that concerns you the most:
Do you believe a person is defined by what she or he does for a living?( ) Yes( ) No
Why?
Politically, you define yourself as
( ) liberal.( ) moderate.( ) conservative.
The worst crime against humanity:
The worst political crime:
OPINIONS
The minimum punishment for molestation:
The minimum punishment for rape:
FAMILY
Three things you like about your mother:
1
2
3
Three things you like about your father:
1
2
3
Which question felt easier to answer?( ) Mother( ) Father
A character or physical trait you inherited from your mother:
FAMILY
Three things you dislike about your mother:
1
2
3
Three things you dislike about your father:
1
2
3
Which question felt easier to answer?( ) Mother( ) Father
A character or physical trait you inherited from your father:
FAMILY
When you were a child, your parents spent
( ) enough time with you.
( ) too much time with you.
( ) not enough time with you.
The most common issue you and your parents have argued about:
The most beautiful childhood memory when you think of your parents:
The most horrifying childhood memory when you think of your parents:
If you didn’t know your parents, you would choose these two people as your mother and your father:
Mother:
Father:
FAMILY
If they were not available, you would choose these two famous people as your mother and your father:
Mother:
Father:
You said “I love you” enough to your mother.( ) Yes( ) No
You said “I love you” enough to your father.( ) Yes( ) No
Your mother told you that she loves you enough.( ) Yes( ) No
Your father told you that he loves you enough.( ) Yes( ) No
Your mother often said:
Your father often said:
Whom do you resemble physically?( ) Mother( ) Father
FAMILY
Something your parents did that you have never forgiven:
What would it take for you to forgive them?
If you had to imagine your mother as an animal, she would be:
If you had to imagine your father as an animal, he would be:
You and your siblings share in common:
A trait you do not share with your siblings:
Your favorite relative is:
Why?
Your least favorite relative is:
Why?
FAMILY
If you were not related to your family members, you would still choose these three as your friends:
1
2
3
If you had to imagine your siblings as animals, they would be:
Name Animal
Something you wish for your mother:
Something you wish for your father:
FRIENDS
Three traits you look for in a friend:
1
2
3
The friend you have known the longest:
Number of years:
Is this person a close friend?( ) Yes( ) No
Why or why not?
Which friend do you miss the most?
When was the last time you saw this friend?
When do you think you will see this friend again?
A friend who makes you laugh often:
A friend to whom you can tell anything:
FRIENDS
A friend to whom you can go for advice:
The best piece of advice this friend gave you:
A friend you can have adventures with:
The best adventure you had with this friend:
A friend you like to flirt with:
A friend you should not flirt with as much as you do:
A friend you would like to kiss:
A friend you should not have kissed:
A friend you don’t take seriously:
A friend you may lose soon:
Why?
FRIENDS
A friend you lost for a reason other than death:
( ) You hope to see this friend again.
( ) You hope never to see this friend again.
( ) If you were to see this friend again, you would be unaffected.
A friend who does or believes in something you cannot respect:
Describe what it is that you cannot respect:
A friend with whom you would like to be closer:
Describe what prevents you from being closer:
A friend to whom you would never lend money:
Why?
FRIENDS
A friend who has betrayed you:
What happened?
Have you forgiven this friend?( ) Yes( ) No
A friend who has done something terrible but whom you have forgiven:
Describe what you have forgiven:
A friend you need to forgive:
A friend you would name as godparent of your child:
A friend to whom you have something important to say, but have not yet had the courage:
What is it that you want to say?
FRIENDS
Your two closest friends:
1
2
One trait you admire in each of them:
1
2
One trait you wish each of them could change:
1
2
An animal that best describes each of them:
1
2
FRIENDS
Your mother is your friend.( ) Yes( ) No
Your father is your friend.( ) Yes( ) No
Your best friend as a child:
Your enemy as a child:
Your best friend as a teenager:
Your enemy as a teenager:
(If you are not yet an adult, leave this blank until you are an adult—then fill out a new All About Me.)
Your best friend as an adult:
Your enemy as an adult:
What should be his punishment?
You are able to forgive your enemy.( ) Yes( ) No
FRIENDS
The friend who is most like you:
Why?
The friend who is most unlike you:
Why?
The friend who uses most of your energy:
A friend you will see in hell:
A friend you will see in heaven:
EGO
Your three best qualities:
1
2
3
Your three worst qualities:
1
2
3
Of these three worst qualities, which one do you struggle with most?
( ) 1( ) 2( ) 3
Which of the three worst qualities have you tried to change?
( ) 1( ) 2( ) 3
EGO
Three words that describe how others view you:
1
2
3
Three words you would use to describe your ideal self:
1
2
3
Three things for which you are often complimented:
1
2
3
Which one of the three is most meaningful to you?
( ) 1( ) 2( ) 3
EGO
A special compliment that made you blush:
Who gave you this compliment?
An insult that made you burn:
How did you react?
You are far better than most people at:
The animal that best describes you:
You are embarrassed when others:
You are embarrassed when you:
Others are embarrassed when you:
The greatest amount of physical pain you have ever endured:
EGO
The greatest amount of emotional pain you have ever endured:
A moment when you have been very proud:
Who shared this moment with you?
The moment you are most ashamed of:
Who shared this moment with you?
When discussing your career with others, you tend to
( ) exaggerate.( ) understate.( ) be factual.
When discussing your love life with others, you tend to
( ) exaggerate.( ) understate.( ) be factual.
When telling stories or relaying the details of your day, you tend to
( ) exaggerate.( ) understate.( ) be factual.
EGO
If you didn’t have commitments to others, you would
How many drinks can you take?
Your best physical feature:
You have considered plastic surgery.( ) Yes( ) No
At your best, you look most like this famous person:
At your worst, you look most like this famous person:
A newspaper headline you would like to read about yourself:
Your most recent selfless act:
WHAT YOU LIKE
Spontaneously list anything that comes to mind.
WHAT YOU DISLIKE
Spontaneously list anything that comes to mind.
YES OR NO
You keep a diary.( ) Yes( ) No
You like to cook.( ) Yes( ) No
You exercise regularly.( ) Yes( ) No
You sketch while you are on the phone.( ) Yes( ) No
You have read a book in the past month.( ) Yes( ) No
You replace the toilet-paper roll immediately.( ) Yes( ) No
You like crossword puzzles.( ) Yes( ) No
You have visited the Eiffel Tower.( ) Yes( ) No
You have a secret you have never shared with anyone.( ) Yes( ) No
Copyright © 1998 by Philipp Keel. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.