Appendix. Today is a great day. Millionaire. Reproduceable Worksheet. Mindset. to download visit
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2 Appendix To Reproduceable Worksheet to download visit 1
3 Reaction Worksheet On this page, write out what you think the reaction would be of each of the people named below if you showed them a list of all the things you would like to acquire in life; your Heart s Desire list. Parents Professor Knowitall (Educators) To Rev. Sour Puss (Religious leaders) Mr. Teeth (Media) Pal Al (Friends) 2 Coach (Gerry Robert) Copyright, Gerry Robert
4 Habit Worksheet 1 Write at least 35 habits and don t worry about prioritizing them yet. Changing or acquiring the following habits would improve the quality of my personal and professional life: To 35. Copyright, Gerry Robert 3
5 SIX Steps to Self-Discipline Worksheet Step 1: Define Purpose What do I want to do? Step 2: Find Role Models Who does it right? To Step 3: See Success What s in it for me? Step 4: Delay Gratification What are the danger zones? Step 5: Use Advanced Decision-Making To what do I commit? 4 Copyright, Gerry Robert Step 6: Get Support Who will hold me accountable?
6 Your Heart s Desire Worksheet If I had UNLIMITED money, time, talent, abilities and support from my family, here s what I would do with my life: My Dream List To Copyright, Gerry Robert 5
7 Goals Mastery Worksheet To s Date: Goal #: Step 1: List the Goal Category: Step 2: Describe the goal. (Be specific.) The goal I will achieve is: Step 3: Give it a deadline. I will have it by: To Step 4: Identify the potential obstacles. Here are the danger zones to watch out for: Step 5: List the skills you will need to develop. To succeed, I will need to work on: 6 Step 6: Identify helpful resources. These people, organizations and resources will help me achieve this goal:
8 Step 7: List the benefits. Here s what s in it for me: Step 8: Develop a workable plan. Here s what has to happen for me to achieve this goal: Step 9: Become accountable. I will ask the following people to hold me to this goal and action plan: To Step 10: List your Action Commitments. I promise to do the following: Copyright, Gerry Robert 7
9 Information current to: Personal Data Name Home Telephone Business Telephone Master Data Worksheet To Date of birth Place of birth Birth Certificate # Located Citizenship Social Security # Other Gov t. # (Explain) Name of spouse Date of birth Place of birth Birth Certificate # Location Citizenship Social Security # Other Gov t.# (Explain) 8 Date of marriage Place of marriage Marriage license is located Names/Birth Dates - Children 1. 4.
10 Adoption papers Yes/No Adoption papers located Employment Data Name of Employer Phone Number Position/Title Reports to Life Insurance coverage Yes/No Policy location Beneficiary Profit-sharing, pensions, other benefits contact Business Interests Business Name Location of business documents/agreements To Company Lawyer Phone Number Home Phone Location of Company Records Physician Name Office Number Home Number Pager Location of my tax returns 9
11 Financial Planner/Name Office Number Home Number Cell Number To Other Family Advisors Name Office Number Home Number Cell Number Life Insurance Data Life Insurance Company Agent Office Number Home Number Cell Number 1. Whole life insurance # Location of policy Coverage amount Term life insurance Location of policy Amount of coverage $ 10 Employment group life insurance coverage $ Automobile Insurance Data Auto Insurance Company & Policy # Agent
12 Office Number Home Number Cell Number Location of policy Policy number for Policy number for Policy number for Amount of deductible House Insurance Data Company Agent Office Number Home Number Cell Number House policy number Location of policy Amount of coverage Amount of deductible Safekeeping Data I have a safety deposit box Yes/No Location Box number Location of keys To Membership Data I am a member of these organizations and clubs Name/Contact/Telephone
13 Real Estate Data Principle Residence I own/i rent Ownership title Other parties with an interest in home 1st mortgage holder/landlord Company Contact name Telephone Mortgage # Monthly payment $ To 2nd mortgage holder Company Contact name Telephone Mortgage # Monthly payment $ 12 Investment Properties Telephone Ownership title Other parties with an interest in this house 1st mortgage holder Company Contact name Telephone Mortgage # Monthly payment $
14 2nd mortgage holder Company Contact name Telephone Mortgage # Monthly payment $ Banking Data Name of bank Telephone Checking Account # Savings Account # Other Location of bank books Credit Card Data Company Card number Interest Rate Grace Period To Loan Data I owe the following people 1. Name Tel. Payments Balance Owing 13
15 Owed to me To Location of Investment Documents Stocks located Bonds located Mutual fund located Other investment records located Last Will Data My will is located The executor/executrix named in my will is (are) In the event of their death 14 Special instructions regarding my funeral are specified in my will, letter, other Location of above documents Copyright, Gerry Robert
16 Monthly Income & Expense Worksheet INCOME PER MONTH Employment (self) Employment (spouse) Multiple Sources of Income Investments Pensions Annuities Settlements Government Interest Dividends Real Estate LESS TOTAL GROSS INCOME 1. Tithe Tax Housing Mortgage (rent) Domestic help Insurance Taxes Electricity Gas Water Sanitation Telephone Maintenance Cable Other To 4. Food 5. Automobile(s) Payments Gas/Oil 15
17 Insurance License Taxes Maintenance Repairs 6. Insurance Life Medical Other 7. Debts Credit Cards Loans Other To 8. Entertainment Eating Out Trips Baby-sitters Hobbies Vacations Other Clothing 10. Savings 11. Medical Expenses Doctor Dentist Drugs Other 1 Miscellaneous Toiletries, cosmetics Beauty, barber Donations Clubs, memberships Public transportation
18 TOTAL EXPENSES TOTAL INCOME : TOTAL EXPENSES : NET INCOME : Parking Books/magazines Laundry, dry cleaning Allowances, lunches Gifts Pets and pet care Special Education Cash/pocket money Other Copyright, Gerry Robert To 17
19 The Mastermind Principles (Begin each session by everyone in the group reading these principles out loud.) Principle #1 I am 100% committed to this Mastermind Group. Principle #2 I am committed to GIVING rather than receiving. Principle #3 I will help without looking for anything in return. To Principle #4 I agree to engage only in no-limit thinking. Principle #5 I respect my partners and agree to build our relationship on trust. Principle #6 I agree to support the dreams, aspirations and goals of my Mastermind partners. 18 Principle #7 I agree to become accountable to my partners. I agree to do what I say I will do. I will take action. Principle #8 Putting aside all cares and concerns, I am positive, enthusiastic, expectant and ready to Mastermind. Copyright, Gerry Robert
20 The Objective: Mastermind Worksheet Name/Telephone Needs List WHAT Name: Telephone: Action Notes Ideas HOW Contacts Name: Telephone: Action Notes Agreement q To Prioritized q Name: Telephone: Action Notes Name: Telephone: Action Notes Copyright, Gerry Robert Name: Telephone: Action Notes Name: Telephone: Action Notes 19
21 Mastermind Schedule Worksheet To Meeting Date: Start Time: Location: Leader: Mastermind Partners End Time: Will Attend Unavailable Attended When the Team Leader for this meeting has checked attendance, everyone should read aloud the Mastermind Principles. The energy of this meeting will stay focused on the objectives below, dealing with one objective at a time Next Mastermind Meeting Scheduled for: Copyright, Gerry Robert
22 PRIORITY SCALE Items to be prioritized PRIORITY SCALE (The list in priority.) PRIORITIES 1 1 s 2 2 s s s s s s s s To
23 Things I put off doing: Procrastination Worksheet This makes me feel? To Is it important? Yes (Why?) No (Why not?) 22 Procrastination Action Plan: Copyright, Gerry Robert
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