Personal Potential - Request the SI report

In order to request your SI report it is necessary to completely fill out this form.

Your Succes Indicator results

My Myers-Briggs Typology is:

My Main Typology is:

My two success-factors are*:

*(select the success-factors with the highest scores)
remark: when you have any doubt about your outcome, please revert to the previous page (back button).

Succes Indicator report (SI)

Type of report to be requested

Rate (€/USD)

Standard

I Macro-level

II Meso-level

III Micro-level

Each part of the entire width and depth profile will be represented by means of easily legible graphs describing all psychological terms. Report consisting of 6 pages.

At this level there are four Main Typologies

Your Main Typology can be either CREATOR, BUILDER, SHAPER or CONTROLLER.

Your Main Typology refers to your role in society

At this level there are sixteen Myers-Briggs Typologies

You have a single or a double Myers-Briggs Typology

Your Myers-Briggs Typology indicates the kinds of positions or professions that suit you

At this level there are four success-factors

The scores for the four success-factors give your Myers-Briggs Typology a distinctive value in comparison to others who obtained the same Myers-Briggs Typology

The four success-factors find their origin in the four fundamental Myers-Briggs traits

€ / US$ 55.00

International

The SI report standard complemented by a written interpretation and consultancy (ca. 3/4 A4).

€ / US$ 144.00

Your request will be confirmed by E-mail.

Which SI report do you wish to receive?

How would you like to receive your report?

By E-mail as a Word2002 Document
By E-mail as a zipped Word2002 Document
By E-mail in .pdf format (Acrobat Reader 7.0)

Do you wish to receive your report as a Word2002 document protected by a password?

Yes, I will receive my password separately by Email
No, a password is not necessary for me

Do you want your name to be mentioned on the frontpage of the report?

YES

NO

How would you like to pay?

By , email address: paypal@personal-potential.com
By wire transfer, IBAN (you pay in Euros): NL95ABNA0493228330 BIC/Swift Code: ABNANL2A, the Netherlands.
By wire transfer, IBAN (you pay in US Dollars): NL30ABNA0556362047; BIC/Swift Code: ABNANL2A, the Netherlands.

As soon as we receive evidence that payment has been made, you will be sent your report as indicated above.

Delivery times:
Airmail: within 10 days after receiving evidence of payment.
E-mail: within 12 hours after receiving evidence of payment.
Evidence of payment: approval of InternetSecure by Email

Important remark:
Your request will be treated seriously, in other words, filling out this form and sending your data implies the actual purchase of the report. Consequently, you will be billed according the type of report you indicated. Therefore we wish to remind you of the great value of the SI report as an investment in yourself.

Please enter your personal data:

Company

Department

Job title

Name *

Date of birth *

Sex Male Female *

Highest level of education *

Field of study (major) *

Nationality *

Address *

Province/State *

Postal/Zipcode *

City *

Country *

Phone *

E-mail *

Fields marked by * are obligatory. Unmarked fields are optional

By E-mail as a Word2002 Document By E-mail as a zipped Word2002 Document By E-mail in .pdf format (Acrobat Reader 7.0) Do you wish to receive your report as a Word2002 document protected by a password?
Yes, I will receive my password separately by Email No, a password is not necessary for me

Company
Department
Job title
Name	*
Date of birth	*
Sex	Male Female *
Highest level of education	*
Field of study (major)	*
Nationality	*
Address	*
Province/State	*
Postal/Zipcode	*
City	*
Country	*
Phone	*
E-mail	*
	Fields marked by * are obligatory. Unmarked fields are optional