User Registration and Timeline Survey

User Registration and Timeline Survey
Register your basic details and share your timeline experiences and plans.
Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Mailing Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Date of Birth
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
How would you rate your satisfaction with your current life timeline?
Which of the following milestones have you achieved? (Select all that apply)
Other

Please indicate your agreement with the following statements regarding your timeline.

Rows	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
I am satisfied with my progress so far.
I feel in control of my timeline.
I have clear goals for the next 5 years.
I am open to unexpected changes in my plans.

What is your main goal for the next year?
When do you plan to achieve your next major milestone?
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
How confident are you in achieving your next milestone on time?

1
2
3
4
5
1 is Not confident, 5 is Very confident
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