Please use this list of common human traits to describe this person

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SURVEY OF PERSONALITY AND VALUES
TO BE COMPLETED BEFORE BEGINNING SURVEY
Please use the information provided on the informed consent form given to you
PERSONAL MATCHING ID:
Class ID number:
_______________
_______________
School/Location (e.g., FAU):
__________________
YOU ARE BEING ASKED TO RATE THE PERSON WHO PROVIDED YOU WITH THE INFORMED
CONSENT FORM ON THEIR PERSONALITY AND VALUES. WHEN COMPLETED PLEASE SAVE THE
SUREY ON YOUR COMPUTER. ACCESS THE FREE EMAIL ACCOUNT THAT ALLOWS YOU TO
ATTACH AND EMAIL THE SURVEY ANONYMOUSLY AT WWW.HOTMAIL.COM EMAIL ADDRESS:
[email protected]
PASSWORD: “ELECTION”. SEND TO [email protected]
Consent Statement:
□I have read or had read to me the preceding information describing this study.
All my questions have been answered to
my satisfaction. I am 18 years of age or older and freely consent to participate. I understand that I am free to withdraw
from the study at any time. I have received a copy of the consent form.
Please use this list of common human traits to describe this person as accurately as possible. Describe how you see
him/her at the present time. Describe him/her as they are generally or typically, as compared with other persons
you know of the same sex and of roughly your same age. Before each trait, please write a number indicating how
accurately that trait describes this person, using the following rating scale:
Inaccurate
Extremely
1
Very
2
Neutral
Accurate
Moderately Slightly
3
4
Slightly Moderately Very
6
7
8
Extremely
9
5
____ Active
____ Distrustful
____ Innovative
____ Rude
____ Undemanding
____ Agreeable
____ Efficient
____ Insecure
____ Self-pitying
____ Undependable
____ Anxious
____ Emotional
____ Intellectual
____ Selfish
____ Unemotional
____ Artistic
____ Energetic
____ Introspective
____ Shallow
____ Unenvious
____ Assertive
____ Envious
____ Introverted
____ Shy
____ Unexcitable
____ Bashful
____ Extraverted
____ Irritable
____ Simple
____ Unimaginative
____ Bold
____ Fearful
____ Jealous
____ Sloppy
____ Uninquisitive
____ Bright
____ Fretful
____ Kind
____ Steady
____ Unintellectual
____ Careful
____ Generous
____ Moody
____ Sympathetic
____ Unintelligent
____ Careless
____ Haphazard
____ Neat
____ Systematic
____ Unkind
____ Cold
____ Harsh
____ Negligent
____ Talkative
____ Unreflective
____ Complex
____ Helpful
____ Nervous
____ Temperamental
____ Unrestrained
____ Conscientious
____ High-strung
____ Organized
____ Thorough
____ Unsophisticated
____ Considerate
____ Imaginative
____ Philosophical
____ Timid
____ Unsympathetic
____ Cooperative
____ Imperceptive
____ Pleasant
____ Touchy
____ Unsystematic
____ Creative
____ Imperturbable
____ Practical
____ Trustful
____ Untalkative
____ Daring
____ Impractical
____ Prompt
____ Unadventurous
____ Verbal
____ Deep
____ Inconsistent
____ Quiet
____ Uncharitable
____ Vigorous
____ Demanding
____ Inefficient
____ Relaxed
____ Uncooperative
____ Warm
____ Disorganized
____ Inhibited
____ Reserved
____ Uncreative
____ Withdrawn
Please rate the individual on how important each of these is as a guiding principle in this person’s life.
Use the scale provided below.
1
Opposed
to their Values
2
Not
Important
3
4
Somewhat
Neutral
Unimportant
5
Somewhat
Important
6
Very
Important
____ 1. A world at peace, free of war and conflict.
____ 2. Social justice, correcting injustice, care for the weak.
____ 3. Equality, equal opportunity for all.
____ 4. Honoring parents and elders, showing respect.
____ 5. Family security, safety for loved ones.
____ 6. Self-discipline, self-restraint, resistance to temptation.
____ 7. A varied life, filled with challenge, novelty, and change.
____ 8. An exciting life, stimulating experiences.
____ 9. Curious, interested in everything, exploring.
____ 10. A sense of accomplishment, lasting contribution.
____ 11. Social recognition, respect, admiration.
____ 12. Self-respect, self-esteem.
____ 13. Freedom, independence, free choice.
____ 14. National security, protection from attack.
____ 15. Personal safety, hazard free environment.
My relationship to this person is (e.g. friend, relative, spouse, etc.): _____________________
My age is: ____________ years
My gender is: ___ Male
How long have you know this person? __________ Years
Thank you for your help!
____ Female
________ Months
7
Of Supreme
Importance
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