| First Name: |
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| Last Name: |
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| Telephone Number: |
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Instructions: Please answer each of the following questions using the rating scale listed below:
SA = Strongly Agree
A = Agree
D = Disagree
SD = Strongly Disagree
Personal Development |
| 1. I have identified my personal strengths. |
| SA A D SD |
| 2. I have developed strategies to maximize my personal strengths. |
| SA A D SD |
| 3. I have identified my personal weaknesses. |
| SA A D SD |
| 4. I have developed strategies to effectively minimize my personal weaknesses. |
| SA A D SD |
| 5. I have increased my self-confidence. |
| SA A D SD |
| 6. I have a high level of self-motivation. |
| SA A D SD |
| 7. I have discovered the importance of giving 110% effort towards everything I do. |
| SA A D SD |
| 8. I have developed clearly defined academic goals. |
| SA A D SD |
| 9. I have developed an extensive knowledge and understanding of my values. |
| SA A D SD |
| 10. I have learned to appreciate and value cultural diversity. |
| SA A D SD |
| 11. I now possess extensive knowledge regarding what it takes for me to be successful. |
| SA A D SD |
| 12. I am extensively aware of what others respect and admire about my personality and leadership style. |
| SA A D SD |
| 13. I have significantly improved my listening skills. |
| SA A D SD |
| 14. I have developed effective time management and stress reduction skills. |
| SA A D SD |
| 15. I have developed a list of characteristics I look for in a mentor. |
| SA A D SD |
| 16. I have a mentor that I meet with at least twice a month to help me with my personal, professional, and/or leadership development. |
| SA A D SD |
| 17. I have developed the ability to critically analyze situations and solve problems with little outside guidance. |
| SA A D SD |
| 18. I have developed the ability to critically analyze situations and solve problems with little outside guidance. |
| SA A D SD |
| Leadership Development |
| 19. I have achieved an extensive knowledge of my personality type. |
| SA A D SD |
| 20. I have developed a comprehensive understanding of Situational Leadership. |
| SA A D SD |
| 21. I have developed a clearly stated written personal leadership development plan. |
| SA A D SD |
| 22. I have become comfortable giving positive feedback. |
| SA A D SD |
| 23. I have become comfortable receiving positive feedback. |
| SA A D SD |
| 24. I have become comfortable giving constructive feedback. |
| SA A D SD |
| 25. I have become comfortable receiving constructive feedback. |
| SA A D SD |
| 26. I have held at least one leadership position in a campus club. |
| SA A D SD |
| 27. I have greatly increased my ability to delegate responsibility and follow-up on activities. |
| SA A D SD |
| 28. I have greatly improved my networking skills and the number of people in my network. |
| SA A D SD |
| 29. I have developed knowledge of ethical practices in leadership. |
| SA A D SD |
| 30. I understand the difference between leadership and followership. |
| SA A D SD |
| 31. I understand cultural influences on leadership. |
| SA A D SD |
| 32. I understand how gender influences leadership. |
| SA A D SD |
| 33. Everyday, I apply the knowledge that I have obtained to reach my potential as an exceptional leader. |
| SA A D SD |
| Team Development |
| 34. I have maximized my ability to build a team by developing trust and increasing communication with others. |
| SA A D SD |
| 35. I have developed the ability to work collaboratively as part of a team. |
| SA A D SD |
| 36. I have learned how to use a planning process to set goals and action plans to achieve team goals. |
| SA A D SD |
| 37. I have gained knowledge about group problem-solving models. |
| SA A D SD |
| 38. I have achieved superior knowledge regarding group roles. |
| SA A D SD |
| 39. I have developed strategies to manage conflict in organizations. |
| SA A D SD |
| 40. I have learned methods of assessing and evaluating organizational effectiveness. |
| SA A D SD |
| Optional Demographic Information |
| 1. Sex: |
Female
Male |
| 2. Age: |
17 or under
18-24
25-34
35-44
45-54
55 or older |
| 3. Race: |
American Indian
Asian / Pacific Islander
Black / African American
Caucasian
Latino /Latina
Other |
| 4. Student Status: |
Full - Time (12 or more credits)
Part - Time (11 or less credits) |
| 5. Degree Program: |
A.A.
A.S.
Vocational Certificate
Other |
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