Rate yourself

I generally like myself 1 2 3 4 5

I have confidence in myself. 1 2 3 4 5
I’m ok with how I look. 1 2 3 4 5
I can handle rude or mean comments 1 2 3 4 5
I have good skills and talents 1 2 3 4 5
I finish what I start 1 2 3 4 5
I am happy for others when they succeed, even those closest to me. 1 2 3 4 5
I see myself as a winner 1 2 3 4 5
I regularly push myself to try new things 1 2 3 4 5
I have accomplished some important things in my life. 1 2 3 4 5
Total

o 40-50: You are on the high road!

o 30-39: You are straddling the high
and low roads!
o 10-29: You are on the low road!
Write any of the following messages on a piece of paper that your family
members or people around you may have sent you, either explicitly or by
implication.
“You’re not trying hard enough.”
“You’re not good enough.”
“You’ll never be able to do that.”
“Why can’t you be more like your brother (sister)?”
“You drive me crazy.”
“Why are you doing this to me?”
“When are you going to grow up?”
“Are you stupid or something?”
“It’s your fault that I’m like this.”
“You could have done better.”
“You don’t have any right to feel angry.”
“How will you ever get anywhere in life?”
“Now look what you’ve done.”
“Can’t you do anything right?”
Rewrite the messages you’d like to eliminate from your mind. Rip them up and
throw them away. Remind yourself that you have a choice about which messages
you continue to tell yourself.
In the frame below, draw or paste a picture of yourself as a newborn. Write your
full name on the line underneath.

I am
___________________________________________________
 Feedback Form
Name: ________________ Father’s Name: ____________________ Date: _____________
Contact No.: ____________________ Title of lecture/workshop: _________________________
Instructions: Please indicate your level of agreement with the statements stated below:
Strongl Agree Neutra Disagree Strongly
y l disagree
Agree
1. The objectives of the workshop were clearly
defined.
2. Participation and interaction were encouraged.
3. The topics covered were relevant to me.
4. The content was organized and easy to follow
5. The materials distributed were helpful.
6. The instructor had a grip over the subject.
7.  The instructor was well prepared.
8. The overall experience of the workshop was useful.
9. The objectives of the workshop were met.
10. The time allotted for the workshop was sufficient.
11. The venue was accessible.
12. The room and facilities were adequate and
comfortable.

14. What did you like most about this workshop?

_____________________________________________________________________________________

15. What aspects of the workshop could be improved?

_____________________________________________________________________________________

_____________________________________________________________________________________

If you want your friends & family members to be benefited from such workshops, please mention their
names & contact.
Name: _____________ Contact: _______________ Name: ______________ Contact: ______________

Name: _____________ Contact: _______________ Name: ______________ Contact: ______________

Name: _____________ Contact: _______________ Name: ______________ Contact: ______________