Telephone:
Face to face
Social networking site:
Text Message:
Email:
Letter:
Other communication:
Money:
Environment:
Well-being:
Drink/Drugs:
Employment:
Bullying:
Other:
Check this box if you have a five year plan:
If you have a job, what do you do?
If you don't already work, what would you like to do?
Check this box if you are concerned about your future:
Check this box if you ever think about your well-being and how to keep it healthy:
What do you think of when we say well-being?
What do you mostly do in your spare time?
On a scale of 1 to 5 how happy would you say you were?
Is there anything you would like to change? (about you or the world)
Name
Would you be interested in working on creative projects such as desk top publishing, magazines,
graphic design, event planning, and awareness campaigns? If one or more of these interests
you let us know:
Would you be interested in taking part in a Bushcraft (as seen on TV with Ray Mears) event?
Contact tel/email:
Age:
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