I love the to-do list that Siha posted on Banana Shoulders the other day -- I don't know if it's just the kind of people we are or if it says something about our play styles, but I too usually have an ongoing list of things I plan to do in the game, and pretty much everything I end up doing in game (from running reputation grinds to leveling up alts) follows the list.
For instance, ever since Burning Crusade came out, the number one item on my to-do list was picking up a Netherwing Drake, and pretty much everything I did after that goal was set (switching over to my Hunter so I could solo the dailies more easily, doing only those quests in game every day, and leveling my professions up just to make the most out of doing them) was targeted at getting that Drake, which made it much sweeter when I finally did. In Northrend, my two main goals going in were to pick up the Kalu'ak fishing pole and to get the Green Proto-drake, and while the Oracles haven't been very giving with the Cracked Eggs so far, I have at least ground out the reps needed for those. My latest goals are to get the mounted Squire (I'm well on my way to the needed Seals) and to finally get a high-level Engineer (so I'm leveling up my Paladin, with the added bonus of having an endgame tank and/or healer whenever I want).
And though this gets a little hokey, I'll actually say that aiming at and meeting my goals in game has actually helped me think about goals in real life the same way. We don't have anything so obviously as questgivers in real life, but setting a goal in game and following it through to completion can help you envision a real life goal as well, and follow that out until you finally reach it. There's so much to do in this game that I think it's very helpful to determine exactly what you want to do as you play. So what's on your to-do list?