Happiness Survey
First Name: ______________________ Last Name: ________________________ Sex: O M O F
Date of Birth: DD MM YY Phone: ________________ Email: _______________________________
Address: __________________________________________________________________________________
City: __________________________State: ___________________________ Pin Code: ___________________
Education: ________________Profession: ________________ Languages Spoken: _______________________
1) In a day, how often are you happy?
O Most Often O Quite Often O Sometimes O Not at all
2) If you are unhappy, what are the reasons for your unhappiness?
O Health O Job/ Business O Family/ Relationships O Friends/ Colleagues
O Society O Yourself
3) Are you troubled by:
O Your own mind O Others Words/ Behavior O Your Lifes Circumstances
O Others Suffering/ Problems in Society
4) Are you interested in being a Volunteer & working for any cause?
O Yes O No
5) If Yes, would you like to volunteer for any of the following:
O Environment O Health & Hygiene O De-addiction O Education
O Senior Citizen Welfare O Safety of Women and Child
6) Have you done any Art of Living Workshop?
O Yes O No
7) Are you doing any spiritual practices?
O Yes, I do. O Not yet, but I intend to do. O I would like to know & try.
O Not Interested
8) Teacher Code of Art of Living Teacher: _____________
Place: _________________________ Date: ______________________ Signature: _______________________
Thank You for registering with Volunteer for a Better India!
Website: www.artofliving.org
Your Surveyor: __________________________ Phone: _____________________________
:__________________ : ____________________ :O O
: DD MM YY : ________________ -:__________________________________
: ______________________________________________________________________________________
: __________________________ : ___________________________ : ____________________
: ________________________ : _________________________ : ________________________
1) , ?
O O O O .
2) , ?
O O / O / O /
O O
3) :
O O / O
O
/
4) ?
O O
5) , :
O O O O
O O
6) ?
O O
7) ?
O O , O
O
8) :____________
: _________________________ : ______________________ : _____________________
: www.artofliving.org
:________________________________________ : ________________________________