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The Ascent Intake Assessment

Welcome! ​We want to be sure that you have the most powerful experience possible. So, we invite you to please answer with complete candor and honesty. This intake survey provides a baseline measure of how your life is working, and where your heart and mind are in this season of life.

We take your information very seriously and understand the nature of our responsibility. We handle this information as confidential and will not share personal information with anybody outside of The Ascent leadership. Any reports or data used anywhere outside of the Ascent weekend will be anonymous.

Thank you for stepping up!

(25 questions - 9 minutes to complete)

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Question 1 of 25

1. Are you generally happy with where you are in life?

A

Very happy

B

Generally happy

C

Average happiness

D

Generally unhappy

E

Very unhappy

Question 2 of 25

2. What part of your life needs the most work?

(Select all that apply)
A

Marriage

B

Parenting of kiddos

C

Friendship Difficulties

D

Prayer life

E

Work-Career Challenges

F

Addressing Fears

G

Believing in & Trusting God

Question 3 of 25

3. What are your expectations and hopeful outcomes for The Ascent weekend retreat? (Please include any details. A better understanding of God working in your life? Personal growth in relation to fears? Understanding your wiring? Hearing how other men cope?)

 

 

 

 

Question 4 of 25

4. How do you view taking risks in your life?

A

I like to stay in my lane, not a fan of taking chances that might fail. I'm risk averse.

B

I'm open to some risk, but the situation needs to be calculated and assessed on the front end.

C

I'm always open to new directions. I like risky challenges in all areas of life, whether projects, exotic food, or adventures off the beaten path.

Question 5 of 25

5. When you first wake up, do you:

A

Check social media?

B

Read NY Times, Wall Street Journal, Forbes, etc?

C

Read a daily devotional?

D

Read scripture or another Holy book?

E

Exercise and get rolling?

F

Jump into the battle of daily life, family and work?

Question 6 of 25

6. I consider myself to be transparent and vulnerable. (This information is helpful to your personality and emotional EQ.)

A

Yes, I'm an open book in all situations.

B

Most of the time with wife and family, but not with work associates.

C

Most of the time with work associates, but struggle to connect with wife and family.

D

Not as much in group situations, whether professional or social.

Question 7 of 25

7. Do you consider yourself to be introverted or extroverted?

A

Highly extroverted. People give me juice!

B

Highly introverted. Much rather process alone and away from groups.

C

A little of both, I get energy from people, but need my time to recharge.

Question 8 of 25

8. All things considered, I'm fearless, tenacious and bold.

A

Correct, I have very little fear and tackle each circumstance that comes my way.

B

Sometimes, but fear creeps in at times, although I fight through.

C

Not my wiring, I'm more methodical and measured, but don't see myself as fearful.

D

I struggle to finish things, and often get stuck overthinking due to fear.

E

Fears have been debilitating for me at several stages of life.

Question 9 of 25

9. This is my view of God.

A

Spiritual with no focus on organized religion.

B

Atheist - no god, no afterlife

C

Agnostic - might be god, the universe, or mother nature

D

Jewish - devout (Reform, Orthodox or Conservative)

E

Jewish by family of origin, but not practicing

F

Muslim by family of origin, but not practicing

G

Muslim - devout

H

Buddhist - devout

I

Hindu - devout

J

Christ follower but turned off by church

K

Christian (Nondenominational, Baptist, Methodist, Presbyterian, etc) & church member

L

Christian by family of origin, but not practicing

M

Hindu by family of origin, but not practicing

Question 10 of 25

10. My Holy book for study, prayer or meditation is: (Pick all that apply)

(Select all that apply)
A

None

B

Tanakh-Torah

C

Quran

D

Daily or weekly devotional (Christian)

E

Daily or weekly devotional (Spiritual/New Age)

F

Bible

G

Bible & daily or weekly devotional

H

Veda (Hinduism)

I

Tripitaka-Pali Canon (Buddhism)

J

Other

Question 11 of 25

11. I view the Bible as the "lens" to make all decisions in my life, both large and small decisions.

A

Yes, it forms my worldview.

B

Yes on some issues, but not in total agreement with all aspects of scripture.

C

No, I trust my instincts or gut. Scripture isn't the "tool" or "vehicle" I use to make decisions.

D

No, I use the culture at large to help me make decisions.

E

Other

Question 12 of 25

12. How often do you pray?

A

Everyday, multiple times a day

B

A few times a week (3-4 prayers)

C

Maybe once a week

D

Maybe once a month

E

Never, not a priority

Question 13 of 25

13. The length of my prayers (whether internally or outloud) are:

A

Close to 5 minutes, sometimes more

B

Around a minute, sometimes closer to two

C

30-second range

D

Maybe 10 seconds, "Lord be with me and my family and friends today. Amen"

Question 14 of 25

14. I believe all religions are true and valid, and a person chooses the one that works best for them.

A

Yes, agree.

B

No, disagree.

C

Not sure whether one is true or all are true.

D

Don't believe in any God.

Question 15 of 25

15. I am committed and passionate about my marriage.

A

Yes, very much.

B

Most of the time.

C

Sometimes, but we have struggled.

D

No, we're having a tough time.

E

I'm single.

Question 16 of 25

16. Briefly describe your relationship with your parents, whether current if they're still alive, or how was it if they've passed?

 

Question 17 of 25

17. How would you describe your relationship with your kids?

A

Very good. We're close and get along well.

B

Pretty good overall. We've had minor challenges.

C

A mixed bag. Some good seasons, but also challenging times.

D

Not many bright spots. They're challenging, and I'm ill-equipped.

E

Very difficult. We're not in a healthy place.

F

I don't have children, my own or step-children.

Question 18 of 25

18. I view my work as the most meaningful and important thing in my life, it defines who I am.

A

Yes, absolutely.

B

Work is important to me, but not the be all end all.

C

Family first, then work as a means to support us.

D

Not happy with my work, and need to make it meaningful in a balanced way.

Question 19 of 25

19. Describe your feelings about your work?(Is it a means to an end? Inspiring and challenging? A total beat-down?)

 

Question 20 of 25

20. I proactively volunteer or serve at local non-profits or ministries.

A

Yes, serving is a regular part of my life, monthly if not more.

B

Sometimes, but want to do more.

C

Once or twice a year.

D

Rarely, no time.

E

Never, not interested.

Question 21 of 25

21. How would you describe yourself when being criticized by another?

A

I have thick skin, it doesn't bother me. I try to evaluate whether they're right.

B

I've learned to deal with it, but I have to work to not push back.

C

I receive it begrudgingly, even when the person is correct in giving it. I eventually own it.

D

I don't like it, and find it difficult to hear. I rarely change even if the criticism is accurate.

E

I don't receive it in any way. It can ruin my day, I stew on it, and often dismiss the person giving it.

Question 22 of 25

22. Where do you receive encouragement in your life? (We're defining encouragement as something deeper than "Nice job!" Think of tangible compliments or support that inspire you.)

 

(Select all that apply)
A

My wife

B

My co-workers

C

My extended family

D

My kids

E

My friends

F

No one I can think of

Question 23 of 25

23. In what areas of your life do you feel you are passive about? What situations or circumstances are you not stepping up, and you know you should be?

 

Question 24 of 25

24. How many close male friends do you have? (The guys you can call at 2am when life has fallen apart. He knows your struggles, secrets and doubts.)

A

More than 5 close friends

B

2-3 close friends

C

1-2 close friends

D

No close friends, only acquaintances

Question 25 of 25

25. What if anything do you wish you had more of from your Christian Community? What's missing?

 

 

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