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This is a feedback request form to be filled out by you so that I can see my personality’s
reflection through my friends and family.
Instructions
In the table below, for each statement, mark how much you agree with on the scale 1-5, where
1=disagree, 2=slightly disagree, 3=neutral, 4=slightly agree and 5=agree.
Sr. # Please evaluate my personality and behaviors 1 2 3 4 5
through the following statements
1 Warm up quickly to others.
2 Hold back from expressing my opinions.
3 I am not easily bothered by things.
11 Postpone decisions.
12 Work hard.