Answer the following questions honestly. There are no right or wrong answers. This is a chance to learn something about yourself.
A. Read the list below. Check the five qualities you most admire in someone your age:
| ___ |
Good grades at school |
___ |
Has money/things |
| ___ |
Good at art, music, and/or dance |
___ |
Attractive to the opposite sex |
| ___ |
Cool clothes |
___ |
Popular/lots of friends |
| ___ |
Smart |
___ |
Liked by teachers |
| ___ |
Mature |
___ |
Caring/sensitive |
| ___ |
Good at sports |
___ |
Healthy/strong |
| ___ |
Not afraid of parents/teachers |
___ |
Funny/sense of Humour |
| ___ |
Good-looking |
___ |
Not influenced by what others say/think |
| ___ |
Tough |
___ |
Other: |
B. Fill in the qualities chosen in Section A in the spaces provided. Circle a rating from 1 to 10 to indicate how much you think that it applies to you.
1 _____________________________________________ |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
2 _____________________________________________ |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
3 _____________________________________________ |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
4_______________________________________________
|
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
5 _____________________________________________ |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
Reprinted, with permission, from Smoke-Free for Life, a smoking prevention curriculum supplement produced by the Nova Soctia Department of Health, Drug Dependency and Tobacco Control Unit, 1996.
