Ladies...
Take this Womens
Self Defense Survey

This womens self defense survey was moved from the Blog Area to this page and combined with the easy-to-use form at the bottom of this page...

I'm conducting a study on what women are, and are not, looking for in a women's self-defense program. Please help me by posting your responses through the comments link at the end of this article.

The reason for my request is that I am putting together several new resources designed just for women on the topic of self-protection for women and girls. Products and services will include:

• ebooks - downloadable directly from the internet

• manuals and videos - focusing on the issues that bother women the most and tempered with what I know to be true about how assailants attack and brutalize women

• articles and special reports - about what you can do to keep yourself safe and "off the radar" of attackers, rapists, and muggers

• as-well-as live and teleseminar-based presentations - that will allow you to...

...learn my methods first-hand and become more confident, powerful and able to control a self-defense encounter with some of the most effective techniques, strategies and tactics ever developed.

Your comments and input are greatly appreciated. Of course, you need not identify yourself and may limit your response to the answers you enter here.

However, you must remember that...

...Everyone who provides information for this survey (as-well-as who they are) will receive, absolutely free, a special report that I will be writing using the information submitted by you and others concerned about women's self-defense issues. This report will be sold to others outside of the contributing group but will be given away to those who help to create it.

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Please answer the following questions, being as honest and detailed as possible. Remember, if you have something to say, regardless of how little you think it will matter, say it. I want to make sure that what I'm offering as help to women about self-defense and personal protection is not only effective and based on real-world statistics, but also something that they will find tremendous benefit in, want to learn from and feel confident in using. So, even if you think it's a little thing, if several hundred other women think it's also a 'little thing' and you all speak up, then - it's not so little is it?

Webmasters and Ezine Publishers: Email to let me know that you would like to offer this survey to your subscriber base and I will allow you to link to this survey from your website. At the end of the survey period, I'll share my findings with you and give you a free copy of the special report.**

** Please remember that the information contained on this web site is protected by federal and international copyright laws. It may not be used, copied, reprinted, transmitted or adapted without the express, written consent of Jeffrey M. Miller and Warrior Concepts International. The data provided through any joint venture will be yours to do with as you please; however, the special report may not be used in violation of copyright laws.

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This Form cannot be submitted until the missing fields (labelled below in red) have been filled in
Please take a second to tell us about yourself.
Please note that all fields followed by an asterisk must be filled in.
First Name
Last Name
E-Mail Address
Web Site URL
Street Address
City
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Country*	CountryUnited StatesCanada----------------AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntiguaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCook IslandsCosta RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribadiNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoFederated States of MicronesiaMoldovaMonacoMongoliaMontserratMoroccoMontenegroMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaS. Georgia and S. Sandwich Isls.Saint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSt. HelenaSt. Pierre and MiquelonSudanSurinameSvalbardSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluU.S. Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamUS Virgin IslandsWallis and Futuna IslandsWestern SaharaYemenYugoslavia (former)ZaireZambiaZimbabwe
Home Phone
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1. Have you ever participated in a martial arts or self-defense course, program or class? If yes, please complete the following questions. If not, skip to #2*
Yes No
1a. If so, what was the course/martial art's name?
1b. How long was the program that you participated in and did you complete it?
1c. What did you like or find most useful in the program?
1d. What did you dislike or feel was missing from the program?
1e. How did you hear about the program?
1f. How much did you pay for the course/class/etc?
2. Do you have books, videos, etc. on the subject of self-defense in general and/or womens self defense specifically? If "yes", please answer the following questions If not, please proceed to #3*
---Select---YES to All (Books, magazines, videos, etc.) Yes - Books only Yes - Videos only I don't own my own but I borrow from libraries, friends, etc. No - I don't own or use them at all
2a. What books, magazines, etc. have you purchased or aquired on the subject?
2b. What do you like or find useful in them?
2c. What do you dislike or feel is missing from them?
2d. On average, how much have you spent, or would you spend on a book or video about womens self defense?
2e. Have you ever purchased an ebook or other internet-based informational product on this subject?*
Yes No I never purchase on the Internet
Regardless of your answer,how likely are you to purchase one if it had what you were looking for?*
---Select---Very Likely Probably Maybe Unlikely Not at all
If your answer above was other than "Very Likely," or "Not at all," What would be the determining factor in whether or not you purchased?*
3. Have you, or any group that you're affiliated with, ever sponsored or hosted a womens self defense program, seminar, workshop, or series of on-going classes?*
Yes No
Regardless of your answer above, 3a. Would you consider doing so as a way to help those in your community to be more safe and secure?
---Select---Yes - Definately Yes - If we had help We would Consider the idea Probably Not No - Not at all
4. How confident are you in your ability to defend yourself in a general self-defense situation (punching/slapping, mugging, etc.)? Feel free to explain your answer (for example: "Very confident if slapped but unsure if wrestled to the ground or pin against a wall," etc.)*
5. How confident are you in your ability to stop a rape attempt?*
---Select---Very Confident Pretty Confident I think I'd do Ok It would depend on the attack and who my assailant was Unsure of what to do I would lose
6. How serious are you about learning how to keep yourself safe from predators and others who might try to harm you?*
---Select---Very Somewhat About the same as every other woman I know A little I try not to think about it Not at all
7. What is/are you greatest concern(s) when it comes to womens self defense issues? In other words - "what scares you the most" when you think about being attacked?*
8. Are you a parent? If "no", please skip to #9*
Yes No
8a. Do you have (a) daughter(s) that you're concerned about?
Yes No(Only boys)
8b. How old is/are she/they?
8c. What scares you most about what they might have to deal with now and as they grow up and move out into the world?
9. Thinking about this subject, what would you like to add to help us to understand your thoughts, feelings and concerns about womens self defense that we have not already asked you?