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* 1. What is your first name?

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* 2. What is your last name?

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* 3. At what email address would you like to be contacted?

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* 4. List your reasons for wanting to talk with me:  please give specific personal and professional detailed reasons.

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* 5. Here are some of the topics that I teach clients and audiences. Check all that you are interested in learning more about so that I have an understanding of your current level of awareness and what you are looking for:

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* 6. If you are already familiar with these topics, please share any challenges that you currently experience with the following:

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* 7. Are you ready NOW to invest time and finances to upgrade your life and to commit to making positive change with the appropriate mentor? Please answer with either  Yes or No in this format:
1. Time - Yes or No
2. Money - Yes or No

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* 8. Please read this carefully. To save time:
Part 1. List anyone with whom you are CURRENTLY working such as a coach, mentor, consultant, and/or healer who addresses Energy Healing, Intuition Development, or Soul Purpose implementation. Please specify their names, their expertise, and the goals that you are committed to accomplish with these professionals.  
Example:
Ms. X - Soul Purpose clarity. Goal: Feel that I am on track with my soul's plan for me in this life time.



Part 2. List with whom you have worked in the past and your overall results achieved with them:
Example: 
* I worked with Ms.X: Results - I came to understand my strongest intuition channels. 

This will give me an understanding of what is already activated and in momentum in the unfolding of your Soul Purpose path. Thank you!

Answer Question In This Format Please: 
Part 1 Answer:

Part 2 Answer:

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* 9. For Business Owners Only:
Part 1:  How much gross income have you earned in your business this year?
(If you do not know this answer, please find out this number, post it here before submitting this application survey.  "I don't know" will disqualify you from having a complimentary session with me. Thank you for valuing both of our time.)

Part 2:  How much gross income do you want to earn next year?


Answer Question In This Format Please:
Part 1  Answer:
Part 2  Answer: 

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* 10. State the one main pain or issue that you must solve for you to have inner peace and feel On Purpose in this life time.

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